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

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

Research output: Contribution to journalArticle

336 Citations (Scopus)

Abstract

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 CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 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. CA1 predominant HS ILAE type 2 and CA4 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.

Original languageEnglish (US)
Pages (from-to)1315-1329
Number of pages15
JournalEpilepsia
Volume54
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Temporal Lobe Epilepsy
Sclerosis
Advisory Committees
Epilepsy
Gliosis
Seizures
Electrophysiology
Age of Onset
Terminology
Hippocampus
Neurons
Wounds and Injuries

Keywords

  • Brain
  • Epileptology
  • Hippocampus
  • Neurology
  • Neuropathology
  • Seizures

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Blümcke, I., Thom, M., Aronica, E., Armstrong, D. D., Bartolomei, F., Bernasconi, A., ... 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, 54(7), 1315-1329. https://doi.org/10.1111/epi.12220

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; Moshe, Solomon L.; Oz, Buge; Özkara, Çiǧdem; Perucca, Emilio; Sisodiya, Sanjay; Wiebe, Samuel; Spreafico, Roberto.

In: Epilepsia, Vol. 54, No. 7, 07.2013, p. 1315-1329.

Research output: Contribution to journalArticle

Blümcke, I, Thom, M, Aronica, E, Armstrong, DD, Bartolomei, F, Bernasconi, A, Bernasconi, N, Bien, CG, Cendes, F, Coras, R, Cross, JH, Jacques, TS, Kahane, P, Mathern, GW, Miyata, H, Moshe, SL, Oz, B, Özkara, Ç, Perucca, E, Sisodiya, S, Wiebe, S & 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, vol. 54, no. 7, pp. 1315-1329. https://doi.org/10.1111/epi.12220
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 ; Moshe, Solomon L. ; Oz, Buge ; Özkara, Çiǧdem ; Perucca, Emilio ; Sisodiya, Sanjay ; Wiebe, Samuel ; Spreafico, Roberto. / International consensus classification of hippocampal sclerosis in temporal lobe epilepsy : A Task Force report from the ILAE Commission on Diagnostic Methods. In: Epilepsia. 2013 ; Vol. 54, No. 7. pp. 1315-1329.
@article{babb2122df8b4c8ab9d120ada6b8ffa1,
title = "International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods",
abstract = "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 CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 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. CA1 predominant HS ILAE type 2 and CA4 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.",
keywords = "Brain, Epileptology, Hippocampus, Neurology, Neuropathology, Seizures",
author = "Ingmar Bl{\"u}mcke and Maria Thom and Eleonora Aronica and Armstrong, {Dawna D.} and Fabrice Bartolomei and Andrea Bernasconi and Neda Bernasconi and Bien, {Christian G.} and Fernando Cendes and Roland Coras and Cross, {J. Helen} and Jacques, {Thomas S.} and Philippe Kahane and Mathern, {Gary W.} and Haijme Miyata and Moshe, {Solomon L.} and Buge Oz and {\cC}iǧdem {\"O}zkara and Emilio Perucca and Sanjay Sisodiya and Samuel Wiebe and Roberto Spreafico",
year = "2013",
month = "7",
doi = "10.1111/epi.12220",
language = "English (US)",
volume = "54",
pages = "1315--1329",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - International consensus classification of hippocampal sclerosis in temporal lobe epilepsy

T2 - A Task Force report from the ILAE Commission on Diagnostic Methods

AU - Blümcke, Ingmar

AU - Thom, Maria

AU - Aronica, Eleonora

AU - Armstrong, Dawna D.

AU - Bartolomei, Fabrice

AU - Bernasconi, Andrea

AU - Bernasconi, Neda

AU - Bien, Christian G.

AU - Cendes, Fernando

AU - Coras, Roland

AU - Cross, J. Helen

AU - Jacques, Thomas S.

AU - Kahane, Philippe

AU - Mathern, Gary W.

AU - Miyata, Haijme

AU - Moshe, Solomon L.

AU - Oz, Buge

AU - Özkara, Çiǧdem

AU - Perucca, Emilio

AU - Sisodiya, Sanjay

AU - Wiebe, Samuel

AU - Spreafico, Roberto

PY - 2013/7

Y1 - 2013/7

N2 - 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 CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 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. CA1 predominant HS ILAE type 2 and CA4 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.

AB - 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 CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 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. CA1 predominant HS ILAE type 2 and CA4 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.

KW - Brain

KW - Epileptology

KW - Hippocampus

KW - Neurology

KW - Neuropathology

KW - Seizures

UR - http://www.scopus.com/inward/record.url?scp=84879793001&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879793001&partnerID=8YFLogxK

U2 - 10.1111/epi.12220

DO - 10.1111/epi.12220

M3 - Article

C2 - 23692496

AN - SCOPUS:84879793001

VL - 54

SP - 1315

EP - 1329

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 7

ER -