{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:19:04Z","timestamp":1790781544402,"version":"4.1.0"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,9]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The authors present their review of 178 patients who underwent <jats:italic>en bloc<\/jats:italic> temporal lobectomies as surgical treatment for intractable epilepsy. Hippocampal cell density was quantitatively analyzed and the histology of the anterior temporal lobe was reviewed. Fifty-four patients (30.3%) had evidence of extrahippocampal lesions in addition to neuronal cell loss within the hippocampus (the dual pathology group). The pattern of cell loss was analyzed in the remaining 124 cases (69.7%) with no extrahippocampal pathology, and compared with that of the dual pathology group and a control group of four nonepileptic patients.<\/jats:p>\n<jats:p content-type=\"fine-print\">Hippocampal cell loss was found in almost all epileptic patients compared to the control group. Severe cell loss greater than 30% of control values was found in 88.7% of patients without extrahippocampal lesions, but in only 51.8% of patients with dual pathology. The difference between these two groups was statistically significant (p &lt; 0.001). In the dual pathology group, lesions of different pathology had a significant relationship with the degree of hippocampal cell loss: all 12 patients with glioma had mild cell loss, whereas all 13 patients with heterotopia were associated with severe cell loss. Severity of hippocampal cell loss was also analyzed in relation to seizure history: a prior severe head injury was associated with severe cell loss. Other factors such as seizure duration, secondary generalization, or family history of seizures were not associated with hippocampal damage. Dual pathology may produce a combination of neocortical and temporolimbic epilepsies that warrants a precise definition of the true epileptogenic area prior to surgical treatment.<\/jats:p>","DOI":"10.3171\/jns.1991.75.3.0364","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T16:16:37Z","timestamp":1242749797000},"page":"364-370","source":"Crossref","is-referenced-by-count":221,"title":["Surgical treatment of limbic epilepsy associated with extrahippocampal lesions: the problem of dual pathology"],"prefix":"10.3171","volume":"75","author":[{"given":"Michel F.","family":"L\u00e9vesque","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobukazu","family":"Nakasato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry V.","family":"Vinters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L.","family":"Babb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Surgical Treatment of the Epilepsies.","first-page":"213","article-title":"Radiological detection of surgically treatable pathology","author":"Adams","year":"1987"},{"key":"b2","series-title":"Ann Neurol","first-page":"699","article-title":"Biological difference between ischemia, hypoglycermia, and epilepsy.","volume":"24","author":"Auer","year":"1985"},{"key":"b3","series-title":"Surgical Treatment of the Epilepsies.","first-page":"511","article-title":"Pathological findings in epilepsy","author":"Babb","year":"1987"},{"key":"b4","series-title":"Epilepsia","first-page":"729","article-title":"Temporal lobe volumetric cell densities in temporal lobe epilepsy.","volume":"25","author":"Babb","year":"1984"},{"key":"b5","series-title":"Soc Neurosci Abst","first-page":"236","article-title":"Light and electron microscopy of mossy fiber terminals in human \u201cepileptic\u201d fascia dentata.","volume":"15","author":"Babb","year":"1989"},{"key":"b6","series-title":"Epilepsia","first-page":"721","article-title":"Distribution of pyramidal cell density and hyperexcitability in the epileptic human hippocampal formation.","volume":"25","author":"Babb","year":"1984"},{"key":"b7","series-title":"Neuroscience","first-page":"351","article-title":"Synaptic reorganization by mossy fibers in human epileptic fascia dentata.","volume":"42","author":"Babb","year":"1991"},{"key":"b8","series-title":"Ann Neurol","first-page":"43","article-title":"The hippocampus in experimental chronic epilepsy: a morphometric analysis.","volume":"27","author":"Bertram","year":"1990"},{"key":"b9","series-title":"The Neuropathology of Temporal Lobe Epilepsy.","author":"Bruton","year":"1988"},{"key":"b10","series-title":"Brain","first-page":"389","article-title":"On certain small tumours encountered in the temporal lobe.","volume":"81","author":"Cavanagh","year":"1958"},{"key":"b11","series-title":"Br Med J","first-page":"1403","article-title":"Aetiological aspects of Ammon's horn sclerosis associated with temporal lobe epilepsy.","volume":"2","author":"Cavanagh","year":"1956"},{"key":"b12","series-title":"Brain Res","first-page":"1","article-title":"Progressive neuronal loss induced by kindling: a possible mechanism for mossy fiber synaptic reorganization and hippocampal sclerosis.","volume":"527","author":"Cavazos","year":"1990"},{"key":"b13","series-title":"Epilepsia","first-page":"389","article-title":"Proposal for revised classification of epilepsies and epileptic syndromes.","volume":"30","year":"1989"},{"key":"b14","series-title":"Brain Res","first-page":"387","article-title":"Hippocampal interneuron loss and plasticity in human temporal lobe epilepsy.","volume":"495","author":"de Lanerolle","year":"1989"},{"key":"b15","series-title":"Neurosurgery","first-page":"792","article-title":"Surgical management of children with temporal lobe epilepsy and mass lesions.","volume":"21","author":"Drake","year":"1987"},{"key":"b16","series-title":"Neurology","first-page":"405","article-title":"Seizure characteristics, pathology, and outcome after temporal lobectomy.","volume":"37","author":"Duncan","year":"1987"},{"key":"b17","series-title":"Arch Neurol Psychiatry","first-page":"27","article-title":"Incisural sclerosis and temporal lobe seizure. 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