Etiology and Pathogenesis of Temporal Lobe Epilepsy

Increasing attention is being paid to the relationship of cerebral lesions to the epilepsies. Gastaut and Fischer-Williams27consider that cases of so-called functional or idiopathic epilepsy (which represent a fault in cerebral function rather than in structure) constitute only about 5% of cases and that most cases of epilepsy have underlying cerebral lesions. These lesions, however, may develop on a "soil" already predisposed to convulsions, which enables a mildly irritative lesion to become markedly epileptogenic. Gastaut24-26,28has also reviewed our present knowledge of the causes of temporal lobe epilepsy, which is a common form of focal or "partial" epilepsy.12,24,35,51However, this knowledge is still incomplete, and as Yakovlev66has pointed out, various lesions may be responsible. In this paper, therefore, we record the pathological findings in 100 consecutive patients with epilepsy submitted to a unilateral temporal lobectomy, and discuss their origin and their significance. Case