Hippocampal sclerosis: causes, symptoms, diagnosis, choice of treatment method, recovery period and medical advice

Under such a medical term as “hippocampal sclerosis”, specialists understand one of the forms of epileptic pathology caused by damage to the limbic system of the brain. The disease is also known as mesial temporal sclerosis.

The indicated pathological process cannot be considered independent. Hippocampal sclerosis has specific symptoms and causes. It is associated with such a key pathology as epilepsy.

The essence of the pathological process

With the development of sclerosis, non-affected organs and soft tissues are replaced by connective tissue having a dense structure. Such a mechanism is capable of provoking factors such as the development of the inflammatory process, age, deterioration of the immune system and addictions. In this regard, taking into account the area of ​​development of the pathological process, tuberous or atherosclerosis, cerebral sclerosis, etc. are distinguished.

What is mesial temporal sclerosis

With this kind of pathology, there is a loss of neurons and scarring of the deepest tissues of the temporal region. As a key cause of hippocampal sclerosis, experts call a severe degree of brain injury. In this case, the pathological process can be observed both in the left and right temporal regions.

Damage to brain structures as a result of trauma, the development of an infectious process, the appearance of a neoplasm, oxygen deficiency or uncontrollable seizures contribute to scarring of tissues, for example, the temporal lobe region. According to statistics, about 70% of patients with temporal lobe epilepsy have temporal mesial sclerosis.

Factors for the development of the disease

As key reasons that can lead to the development of a designated ailment, experts cite:

1. Hereditary factor. In those people whose parents or relatives suffered from manifestations of sclerosis or temporal lobe epilepsy, the likelihood of developing mesial temporal sclerosis is high.
2. Convulsions of a febrile nature, which lead to certain metabolic disorders. Against this background, edema of the cortex of the temporal lobe and destruction of neuron cells occurs, tissues atrophy and the volume of the hippocampus decreases.
3. Various mechanical injuries, for example, a skull fracture, blows to the head or a collision can lead to irreversible disturbances and the development of the indicated pathology.
4. Harmful habits, expressed in the abuse of alcoholic beverages or drug addiction, contribute to the destruction of brain cells and the disruption of neural connections. Thus, chronic alcoholism and hippocampal sclerosis can be combined with a causal relationship.
5. Trauma, for example, abnormal development of the temporal region during the period of fetal development or trauma received during labor.
6. Oxygen deficiency in brain tissue.
7. Infectious process, for example, meningitis, encephalitis and other inflammatory processes in the brain tissue.
8. Intoxication of the body for a long time.
9. Disturbed blood circulation in the tissues of the brain.

As risk factors that can provoke the indicated pathological process, experts distinguish:

• cerebral stroke;
• hypertonic processes;
• the presence of diabetes;
• age - as experience shows, in older people a similar disease is detected much more often than in young people.

Observed clinical picture

The development of mesial temporal sclerosis can provoke focal epilepsy. Epileptic seizures can begin with the fact that a person experiences strange sensations, hallucinations or illusions, which subsequently turn to a stupor of the gaze, as well as food or rotational impulses. This condition can last for two minutes. As the disease develops, tonic-clonic convulsive conditions are observed.

The state of seizures in hippocampal sclerosis is accompanied by such manifestations as:

• changes in behavior;
• decreased ability to remember;
• headache;
• state of increased anxiety;
• sleep disturbances;
• panic attack state.

Patients with a similar diagnosis exhibit impaired cognitive skills, including memory, thinking, and concentration. A seizure condition resulting in a malfunction of the brain can provoke an unexpected loss of consciousness, as well as a malfunction of the autonomic-cardiac system.

When epileptic seizures occur, patients have auditory or vestibular hallucinations, which occurs against the background of belching and unilateral twitching of the face. Such patients experience difficulties in the learning process and impaired memory. These people are characterized by an increased sense of duty, conflict and emotional lability.

Diagnostic measures

Neuropathologists are involved in the diagnosis of the indicated condition. This specialist should be consulted in case of manifestation of the clinical picture described above. During the first visit, the attending physician will talk with the patient to collect an anamnesis. During the dialogue, the doctor assesses the intellectual capabilities of the patient and determines the features of behavior. If emotional or intellectual deviations are detected, the patient is referred for examination to a psychiatrist.

In addition, the medical specialist will undertake a series of manipulations to assess the patient's reflexes:

• in the knee joint;
• in the carpal beam joint;
• as well as the reflex function of the biceps of the shoulders.

During the diagnosis, the patient undergoes the following studies:

1. An electroencephalogram allows you to identify existing foci of a pathological brain impulse.
2. CT and MRI make it possible to take a layered image of the brain and other structures of the cranium.
3. Angiography determines the presence of disorders in the bloodstream of the brain.
4. ECHO is an encephalogram, which is relevant if the patients are newborns or young children.

Therapeutic measures

In order to treat hippocampal sclerosis, anticonvulsants are mainly used. In this case, the appointment and dosage of the drug should be prescribed exclusively by the attending physician. Self-treatment in this situation is excluded.

It is important to note that the absence of seizures suggests that the patient is recovering. The dosage of drugs in this case is reduced if there are no convulsions for 2 years. Cancellation of medication is allowed only if convulsions are completely absent for 5 years. In this situation, drug treatment is designed to provide a general recovery.

Surgical intervention

If conservative therapy has not brought proper results, then surgical treatment of hippocampal sclerosis is prescribed. With the indicated pathological processes, several types of surgical intervention are used. Under the circumstances, as a rule, resort to temporal lobotomy.

In the process of lobotomy, the surgeon excises the affected area of ​​the brain. Before an operation is performed on the right with hippocampal sclerosis or surgery on the left, the doctor must make sure that the excised part of the brain is not responsible for the vital functions of the body. With lobotomy, the surgeon removes a certain part of the temporal lobe.

If the procedure was carried out by an experienced and qualified specialist, then a positive effect is manifested in about 55-95% of patients.

The purpose of the operation for hippocampal sclerosis

The purpose of surgery for the indicated pathology is to relieve the patient of seizures and to cancel or reduce the dosage of the drug. According to statistics, 20% of patients undergoing surgery stop taking anticonvulsant drugs. In addition, in the presence of seizures, patients are always at risk of sudden death. This fact also serves as one of the reasons for surgical intervention.

In the case of surgery, there is always a risk of neurological deficit, which is minimized if the surgeon has the proper experience. One of the main problems from this point of view remains the probability of memory impairment in patients.

Preventive actions

In order to reduce the frequency of seizures, experts recommend regularly taking prescribed medications, as well as:

1. To observe the regime of rest and sleep, it is necessary at the same time to go to bed and wake up.
2. Adhere to a diet, which should limit the consumption of spicy, salty and fried foods, as well as liquids.
3. Refuse the consumption of alcoholic beverages, alcohol-containing products leads to the development of many different diseases.
4. Exclude the consumption of tobacco products - tobacco and combustion products adversely affect all body systems.
5. Avoid overheating or overcooling the body, for this you should exclude visits to baths and saunas, sunbathing in the open sun.
6. Exclude the consumption of tea and coffee.

Conclusion and Conclusions

All proposed measures will help maintain the condition at an adequate level and reduce or completely eliminate the frequency of seizures. Thus, in case of hippocampal sclerosis, surgical treatment and recovery play an important role in maintaining the patient’s health for the rest of his life.

As you know, everyone should be careful about their own health. This statement is especially relevant for people with diagnosed hippocampal sclerosis.