Evaluation of dual pathology among drug-resistant epileptic patients with hippocampal sclerosis

  • Jafar Mehvari Habibabadi
  • Shervin Badihian
  • Nasim Tabrizi
  • Navid Manouchehri
  • Mohammad Zare
  • Reza Basiratnia
  • Majid Barekatain
  • Houshang Moein
  • Amirali Mehvari Habibabadi
  • Payam Moein
  • Peyman GookizadehEmail author
Original Article



Dual pathology (DP) is defined as simultaneous presence of hippocampal sclerosis (HS) and any other pathology in the brain. Since this is a less probed concept, we aimed to evaluate the frequency and characteristics of DP among drug-resistant epileptic patients with HS.


This is a cross-sectional study conducted during 2007–2016 in Kashani Comprehensive Epilepsy Center, Isfahan, Iran. Patients with diagnosis of drug-resistant epilepsy and HS were enrolled in the study, and demographic data, seizure semiology, EEG findings, and MRI findings were collected. We compared these variables between three groups of DP, unilateral HS, and bilateral HS.


Of the 200 enrolled cases, 29 patients (14.5%) had DP and 21 patients (10.5%) had bilateral HS; the remaining patients had unilateral HS. The average age of patients with DP was 30.03, and 65.5% of them were male. Patients with DP had more EEG discharges from regional and multi-focal sites compared to unilateral HS (P value < 0.001). Also, complex partial seizure (CPS) was more commonly presented in patients with unilateral HS (96.8%). Comparison of disease characteristics between DP and bilateral HS showed no difference in most categories (P > 0.05).


We found DP among 14.5% of our drug-resistant epileptic patients with HS. DP patients mostly presented with CPS and had high proportion of ictal and interictal EEG discharges from regional and multi-focal areas. Gliosis and focal cortical dysplasia were the most common pathologies among DP patients. Patients with DP showed a similar behavior to bilateral HS in many features.


Hippocampal sclerosis Dual pathology Drug-resistant epilepsy Mesial temporal sclerosis 



We wish to thank vice-chancellor for research and technology of Isfahan University of Medical Sciences for supporting and funding this project (grant number 394004).


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Copyright information

© Fondazione Società Italiana di Neurologia 2018

Authors and Affiliations

  • Jafar Mehvari Habibabadi
    • 1
  • Shervin Badihian
    • 1
    • 2
  • Nasim Tabrizi
    • 3
  • Navid Manouchehri
    • 1
    • 2
  • Mohammad Zare
    • 1
  • Reza Basiratnia
    • 1
  • Majid Barekatain
    • 1
  • Houshang Moein
    • 1
  • Amirali Mehvari Habibabadi
    • 1
  • Payam Moein
    • 4
  • Peyman Gookizadeh
    • 1
    • 2
    • 5
    Email author
  1. 1.Isfahan Neurosciences Research CenterIsfahan University of Medical SciencesIsfahanIran
  2. 2.Students’ Research Center, School of MedicineIsfahan University of Medical SciencesIsfahanIran
  3. 3.Neurology Department, Medical SchoolMazandaran University of Medical SciencesSariIran
  4. 4.Department of NeurologyUniversity of Tennessee Health Science CenterMemphisUSA
  5. 5.IsfahanIran

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