Hippocampal sclerosis dementia

Rarely considered in the differential diagnosis of dementia, even by cognitive specialists, hippocampal sclerosis (HS) may be the primary cause of dementia (HSD) when it occurs in the elderly population. The articles by Blass et al.1 and Hatanpaa et al.2 in this issue of Neurology characterize clinical and neuropathologic features from a series of HSD patients. Although other investigators have attempted to define a distinct clinical profile for HSD, the cognitive features that differentiate HSD from other dementia subtypes remain largely elusive. Blass et al. and Hatanpaa et al. use retrospective data to paint a portrait of HSD as a variant of frontotemporal dementia (FTD). The report by Blass et al.1 is a case-control study whose strength is that it characterizes clinical features of subjects with “pure” HSD. Most previous studies included HSD patients meeting concurrent criteria for other neurologic diagnoses. Previous cross-sectional studies show few …