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International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods

Blümcke, Ingmar, Thom, Maria, Aronica, Eleonora, Armstrong, Dawna D., Bartolomei, Fabrice, Bernasconi, Andrea, Bernasconi, Neda, Bien, Christian G., Cendes, Fernando, Coras, Roland, Cross, J. Helen, Jacques, Thomas S., Kahane, Philippe, Mathern, Gary W., Miyata, Haijme, Moshé, Solomon L., Oz, Buge, Özkara, Çiğdem, Perucca, Emilio, Sisodiya, Sanjay, Wiebe, Samuel, Spreafico, Roberto·2013·Epilepsia

Abstract

Summary: Hippocampal sclerosis (HS) is the most frequent histopathology encountered in patients with drug‐resistant temporal lobe epilepsy (TLE). Over the past decades, various attempts have been made to classify specific patterns of hippocampal neuronal cell loss and correlate subtypes with postsurgical outcome. However, no international consensus about definitions and terminology has been achieved. A task force reviewed previous classification schemes and proposes a system based on semiquantitative hippocampal cell loss patterns that can be applied in any histopathology laboratory. Interobserver and intraobserver agreement studies reached consensus to classify three types in anatomically well‐preserved hippocampal specimens:HS International League Against Epilepsy (ILAE) type 1 refers always to severe neuronal cell loss and gliosis predominantly in CA 1 and CA 4 regions, compared to CA 1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA 4 predominant neuronal cell loss and gliosis (HS ILAE type 3). Surgical hippocampus specimens obtained from patients with TLE may also show normal content of neurons with reactive gliosis only (no‐HS).HS ILAE type 1 is more often associated with a history of initial precipitating injuries before age 5 years, with early seizure onset, and favorable postsurgical seizure control.CA 1 predominant HS ILAE type 2 and CA 4 predominant HS ILAE type 3 have been studied less systematically so far, but some reports point to less favorable outcome, and to differences regarding epilepsy history, including age of seizure onset. The proposed international consensus classification will aid in the characterization of specific clinicopathologic syndromes, and explore variability in imaging and electrophysiology findings, and in postsurgical seizure control.

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Metadata

Authors
Blümcke, I., Thom, M., Aronica, E., Armstrong, D. D., Bartolomei, F., Bernasconi, A., Bernasconi, N., Bien, C. G., Cendes, F., Coras, R., Cross, J. H., Jacques, T. S., Kahane, P., Mathern, G. W., Miyata, H., Moshé, S. L., Oz, B., Özkara, Ç., Perucca, E., Sisodiya, S., Wiebe, S., & Spreafico, R.
Venue
Epilepsia
Publisher
Wiley
Published
2013-05-20
Volume
54
Issue
7
Pages
1315-1329
ISSN
  • 0013-9580 (ISSN-L)
  • 1528-1167
OpenAlex
W2015513895
Cited by
1,010
References
101
FWCI
31.90
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods. https://app.cochat.ai/papers/10.1111/epi.12220
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Blümcke, I., Thom, M., Aronica, E., Armstrong, D. D., Bartolomei, F., Bernasconi, A., Bernasconi, N., Bien, C. G., Cendes, F., Coras, R., Cross, J. H., Jacques, T. S., Kahane, P., Mathern, G. W., Miyata, H., Moshé, S. L., Oz, B., Özkara, Ç., Perucca, E., . . . Spreafico, R. (2013). International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods. Epilepsia. https://doi.org/10.1111/epi.12220

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