E-Pearl of the Week: "Burned-out Hippocampus" Syndrome

October 31, 2011

Share:

Interested in submitting an e-Pearl? Click here!

Brought to you by the Resident and Fellow Section of Neurology®.

October 25, 2011

"Burned-out Hippocampus" Syndrome

Scalp EEG recordings from temporal lobe epilepsy patients with unilateral hippocampal sclerosis may rarely demonstrate the majority of seizures appearing to originate over the contralateral temporal lobe. Termed "burned-out hippocampus" syndrome, this generally occurs in the setting of a severely atrophic hippocampus. A proposed explanation is that the extensive atrophy precludes sufficient ipsilateral neocortical recruitment to generate a surface discharge prior to seizure propagation (probably via the dorsal hippocampal commissure) into the contralateral temporal lobe. This is supported by invasive depth electrode recordings which have demonstrated mesial temporal lobe seizure onset ipsilateral to the atrophic hippocampus.

References

  1. Mintzer S, Cendes F, Soss J, et al. Unilateral hippocampal sclerosis with contralateral temporal scalp ictal onset. Epilepsia 2004;45:792-802.

Submitted by: Indranil Sen-Gupta, MD

Disclosures: Dr. Sen-Gupta reports no disclosures.

For more clinical pearls and other articles of interest to neurology trainees, visit www.neurology.organd click on the link to the Resident and Fellow Pages. Click here to visit the E-Pearl of the Week Archive.

Click here to listen to this week's Neurology® Podcast.