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