In order to more precisely define temporomedial epilepsy with hippocampal sclerosis, we evaluated 20 patients with magnetic resonance imaging findings of it: 1. Abnormal high signal of the hippocampus on T2 and Flair, 2. Hippocampal atrophy and 3. Structural deformity in hippocampus. 6 patients (55%) had history of febrile seizures during early chilhood or infancy. 4 patients (36%) had head trauma and 1 patient (9%) had neonatal hypoxia. The mean age of seizure onset was 18 years. All patients had complex partial seizures at onset.15 patients (75%) had auras, with abnormal abdominal visceral sensation being the most common type (40%). 11 patients with identified risk factors had an interval between the presumed cerebral insult and the development of habitual seizures, with a mean seizure free interval of 11 years. All patients had oroalimentary automatisms, and 14 patients (70%) also had other automatisms. 9 patients (45%) had lateralizing signs, 6 patients had contralateral version of the head and eyes and 3 patients had dystonic posturing of the contralateral upper extremity. 15 patients (75%) had an abnormal electroencephalogram. 13 patients (87%) showed paroxysmal abnormalities that were localized in the anterior temporal region, over the side of the hippocampal sclerosis in 12 patients and over one temporal lobe in 1 patient with bilateral hippocampal sclerosis with paroxysmal activity. . 2 patients (13%) had interictal bilateral temporal slowing, these patients had bilateral hippocampal sclerosis.

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