Wednesday, March 12, 2008

The Early Descriptions of Ammon's Horn Sclerosis

A reader requested a post about epilepsy. In searching the internet, I found a nice article by Keiji Sano from Teikyo University School of Medicine in Japan which describes the history of hippocampal epilepsy surgery for Ammon’s horn sclerosis (AHS). Here’s an excerpt from Sano’s article. I should note that when Sano refers to the “endplate” or “end folium”, he is referring to the CA4 region of the hippocampus, which I have now learned can also be referred to as Bratz’s sector:
“The first gross description of AHS is generally credited
to Bouchet and Cazauvieilh, who in 1825 observed
changes of sclerosis or softening in the hippocampus
of epileptic as well as of nonepileptic psychopathic
patients. Sommer performed the first microscopic examination
of AHS in 1880, showing the changes to be
restricted to the band of pyramidal cells of the hippocampus,
which has since been called “Sommer’s sector.”
He also coined the term “Amrnonshornsklerose.”
In 1889, Chaslin described a marginal gliosis in cases
of epilepsy and regarded AHS sclerosis as representing
merely a site of predilection for such gliosis. In 1899,
Bratz confirmed Sommer’s findings but noted that
the endplate or the end folium was as often affected as
Sommer’s sector (and therefore later called Bratz’s sector)
and that a portion of the dorsal cell band was resistant
in many cases. He determined that AHS existed in
25 of 50 cases of idiopathic epilepsy and also noted the
same lesion in other diseases associated with convulsive
Epilepsia, 38(Suppl. 6):4-10, 1997
Lippincott-Raven Publishers, Philadelphia
0 International League Against Epilepsy

Here’s a link to the full article:


JD said...

Interesting. However, I find epilepsy specimens to be the most frustrating to sign out. Most of the time, I have to do a lot of hand-waving to come up with an abnormality. My favorite such abnormality is Chaslin's gliosis. Sometimes that is my only diagnosis. The most dramatic case of mesial temporal sclerosis I've ever seen was in a homicide victim with no history of epilepsy.

JD said...

Someone changed the Wikipedia page and deleted the reference to my being a neurologist (and added Richard Prayson's name). I had to reinstate the dinosaur reference.

Anonymous said...

Thanks for quickly responding to my request. This is interesting. I thought that Ammons's horn sclerosis was first described by Sommer.

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