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Wyler scale


Hippocampal sclerosis




Grade I


Mild mesial temporal damage: gliosis with slight (<10% or no) hippocampal dropout, involving sectors CA1, CA3, and/or CA4 of the hippocampal pyramidal cell layer.


Grade II


Moderate mesial temporal damage: gliosis with moderate (10-50%) neuronal dropout, involving sectors CA1, CA3, and/ or CA4 of the hippocampal pyramidal cell layer.


Grade III


Moderate to marked mesial temporal damage (hippocampal sclerosis or "classic" Ammon's horn sclerosis): severe damage (gliosis with >50% neuronal dropout) involving sectors CA1, CA3, and CA4 of the hippocampal pyramidal cell layer but sparing CA2, the resistant sector.


Grade IV


Marked mesial temporal damage (hippocampal sclerosis or "total" Ammon's horn sclerosis): severe damage (gliosis with >50% neuronal dropout) involving all sectors of hippocampal pyramidal cell layer can be seen. The fascia dentata, subiculum, and parahippocampal gyrus may also be involved.




Reference




Wyler AR, Dohan C Jr, Schweitzer JB, Berry AD III. A grading system for mesial temporal pathology (hippocampal sclerosis) from anterior temporal lobectomy. Journal of Epilepsy. Elsevier; 1992;5(4):220-5.


International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods(pages 1315–1329)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. Moshé, Buge Oz, Çiğdem Özkara, Emilio Perucca, Sanjay Sisodiya, Samuel Wiebe and Roberto Spreafico
Article first published online: 20 MAY 2013 | DOI: 10.1111/epi.12220. EPILEPSIA.

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