The Epilepsy Institute of New Jersey is a team of board-certified neurologists and neurosurgeons who provide expert care for a variety of pediatric neurological conditions, including mesial temporal sclerosis (MTS). Our team uses advanced diagnostic tools and innovative treatment techniques to ensure the best outcomes for your child.
The Physical Impact
Mesial temporal sclerosis (MTS) refers to scarring or loss of neurons in the inner (mesial) structures of the temporal lobe, most notably the hippocampus. This damage often leads to recurrent seizures, typically focal seizures that can evolve into more generalized episodes. Because the temporal lobe plays an important role in memory, emotions, and behavior, children with MTS can experience learning challenges, behavioral changes, and difficulties with everyday functioning if the condition remains untreated.
How Common Is This Condition?
Mesial temporal sclerosis is one of the most common causes of drug-resistant (refractory) epilepsy in both children and adults, though it may not be diagnosed until repeated seizures prompt advanced imaging studies. Risk factors and underlying causes may include febrile seizures in early childhood, head trauma, or infections such as encephalitis.
Risk Factors:
- History of prolonged or frequent febrile seizures
- Previous head injury or traumatic brain injury
- Inflammatory or infectious conditions affecting the brain (encephalitis)
- Genetic predisposition to epilepsy or seizures
Signs and Symptoms
Children with mesial temporal sclerosis may present with:
- Focal Seizures: Commonly originating in the temporal lobe, potentially spreading to other areas.
- Auras or Warning Signs: Sensory distortions, déjà vu, or unusual smells/tastes before a seizure.
- Memory Difficulties: Particularly with forming new memories or recalling events.
- Behavioral Changes: Irritability, mood swings, or challenges in social settings.
- Learning Challenges: Problems with concentration and academic performance due to frequent seizure activity.
How We Diagnose
At the Epilepsy Institute of New Jersey, diagnosing mesial temporal sclerosis involves a careful review of your child's seizure history, neurological status, and developmental milestones. We use a range of diagnostic tools to confirm MTS and understand its extent:
- MRI (Magnetic Resonance Imaging): High-resolution scans can reveal the characteristic hippocampal shrinkage or scarring indicative of MTS.
- EEG (Electroencephalogram): Detects abnormal electrical activity in the temporal lobe.
- Video-EEG Monitoring: Correlates seizures with brain wave patterns and confirms the focal origin.
- Neuropsychological Assessments: Evaluates memory, cognition, and behavior to gauge the condition's impact on development and learning.
This thorough diagnostic process enables us to create a personalized treatment plan best suited to your child's needs.
Treatment Options
Managing mesial temporal sclerosis aims to control seizures, protect cognitive function, and support your child's overall well-being. Treatment options include:
- Medications: Anti-seizure drugs may help reduce seizure frequency, though some children with MTS may have drug-resistant epilepsy.
- Surgical Intervention: If seizures remain uncontrolled, surgical resection of the affected temporal lobe area (often the hippocampus) can dramatically reduce or even eliminate seizures.
- Dietary Therapies: The ketogenic or modified Atkins diet may be beneficial in certain cases of refractory epilepsy.
- Medical Devices: Vagus nerve stimulation (VNS) or other neuromodulatory treatments might help reduce seizure severity.
- Rehabilitation and Support: Coordination with therapists, educators, and support services to address any cognitive or behavioral issues and promote optimal development.
Our multidisciplinary approach at the Epilepsy Institute of New Jersey ensures that each child benefits from state-of-the-art procedures and comprehensive care tailored to their specific needs.
Our Commitment to Your Child's Health
“I am neurosurgeon living in New Jersey, board-certified by both the American Board of Neurosurgery (ABNS) and Pediatric Neurosurgery (ABPNS). I specialize in the surgical treatment of complex epilepsy and serve as the Director of the Epilepsy Institute of New Jersey, Chief of Pediatric Epilepsy Surgery at Sanzari Children's Hospital, and Chief of Pediatric Neurosurgery at Children's Hospital of NJ, where I provide exceptional care for children with complex neurological conditions. Your child's health and well-being are our top priorities.”
