Evidence for an Anatomical Substrate of Hyperexcitability in Human Temporal Lobe Epilepsy: Gluta M Ate Receptor Alt E R Ations and Reorganized

In the human, the erratic symptoms associated with spontaneous neural activity, generated by bursts of electrical brain impulses, have contributed to the age-old folklore and superstitions associated with epilepsy. Epilepsy affects 1-2% of the population, and specifically temporal lobe epilepsy (TLE) afflicts 50% of all adults with seizures. In contrast to generalized epileptic seizures, which affect the whole brain, TLE is a disorder manifested by complex partial seizures with epileptic foci within temporal lobe structures such as: hippocampus, amygdala and associated entorhinal, perirhinal, parahippocampal cortices and temporal neocortical areas. Temporal lobe epilepsy is a constellation of symptom complexes with many causes and in which a significant subset of patients are refractory to medical intervention and suffer a resultant deterioration in cognitive, memory, neuropsychological and psychosocial functions (1). In 1825 Bouchet observed that in the epileptic brain the areas most affected were the hippocampus and the cerebellum (2). Sommer in 1880 was the first to correlate a sclerotic hippocampus with TLE (3). Although the next hundred years brought more precise descrip-