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Are complex partial seizures a sequela of temporal lobe dysgenesis?

1. Complex partial seizures are closely associated with a group of discrete neuropathological entities which include focal lesions (such as hamartomas and heterotopias) and small vascular lesions, all of which are generally considered to have been present at birth. 2. The pathological change most frequently found in patients with temporal lobe epilepsy is mesiotemporal sclerosis. Although this pathological alteration in subicular and hippocampal structures has been attributed to any one of a number of perinatal or postnatal insults, we suggest that it also may represent a sequela of disturbed neuroembryogenesis. 3. We suggest that many, perhaps most, cases of temporal lobe epilepsy may resemble other major disorders of cognition and behavior (such as schizophrenia) in representing the sequelae of temporal lobe dysgenesis.