20:T41e,Increasing attention is being paid to the relationship of cerebral lesions to the epilepsies. Gastaut and Fischer-Williams²⁷consider that cases of so-called functional or idiopathic epilepsy (which represent a fault in cerebral function rather than in structure) constitute only about 5% of cases and that most cases of epilepsy have underlying cerebral lesions. These lesions, however, may develop on a "soil" already predisposed to convulsions, which enables a mildly irritative lesion to become markedly epileptogenic. Gastaut^24-26,28has also reviewed our present knowledge of the causes of temporal lobe epilepsy, which is a common form of focal or "partial" epilepsy.^12,24,35,51However, this knowledge is still incomplete, and as Yakovlev⁶⁶has pointed out, various lesions may be responsible. In this paper, therefore, we record the pathological findings in 100 consecutive patients with epilepsy submitted to a unilateral temporal lobectomy, and discuss their origin and their significance.

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21:T45b,We performed a prospective study correlating magnetic resonance imaging volume measurements of the hippocampal formation with histopathology in 24 patients with intractable partial epilepsy who subsequently underwent an anterior temporal lobectomy for their seizure disorder. Patients with mass lesions verified pathologically were excluded from this study. In 71% of patients, quantitative hippocampal formation atrophy correctly lateralized the temporal lobe of seizure origin; in 29%, the volume study was indeterminant. The severity of the pathological alterations in the hippocampus correlated with the hippocampal formation volume determination. Mesial temporal sclerosis was identified in the surgically excised temporal lobe in 15 patients. The magnetic resonance imaging volume studies indicated hippocampal atrophy in the temporal lobe resected in 14 of the 15 patients. Magnetic resonance imaging-based volume measurements of the hippocampal formation increase the diagnostic yield of magnetic resonance imaging scanning in patients with intractable partial epilepsy related to mesial temporal sclerosis.22:T682,

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