Mesial temporal (Ammon's horn) sclerosis as a common cause of epilepsy. Aetiology, treatment, and prevention.

Abstract Mesial temporal (Ammon's horn) sclerosis is the most common single lesion to be found post mortem in the brains of chronic epileptics who die a natural death. Its significance has long been a matter of dispute. Evidence shows that it usually arises in infancy, often as a result of a prolonged febrile convulsion, and that it then becomes a potent epileptogenic lesion. It is usually unilateral. The results of operation for epilepsy are often excellent whenever this lesion is found in the resected specimen. It can be produced experimentally in adolescent baboons by inducing serial epileptic attacks or status epilepticus. Paediatricians in Copenhagen have shown that, by timely treatment of severe febrile convulsions in infants followed by prophylactic therapy with phenobarbitone, later habitual epilepsy can be avoided. Thus both Ammon's horn sclerosis and its consequent epilepsy are probably preventable.