Under what circumstances can seizures produce hippocampal injury: evidence for age-specific effects

Mesial temporal sclerosis (MTS) is the characteristic hippocampal pathology of temporal lobe epilepsy in adults. Both clinical and experimental studies indicate that although the immature brain is highly susceptible to seizures, it is more resistant to the development of the seizure-induced hippocampal pathology akin to MTS, compared with the adult brain. However, seizures in the immature brain may produce age-specific effects on hippocampal morphology or function. The spectrum of these effects is still unknown. Factors such as the presence of prior neurological abnormalities, age, etiology of the seizures, repetitive seizures and genetic predisposition may affect the range and severity of hippocampal changes. The key point is to identify the significance of these changes and design age-appropriate preventative treatments.