Mesial temporal sclerosis (MTS) is a pathology usually seen in young individuals. It is responsible for partial seizures, with possible secondary generalization. It may be initially managed with antiepileptic agents, but eventually some patients may be refractory to medical treatment. Authors report the case of a 21 year old man with generalized tonic–clonic seizure and a suggestive cerebral MRI for bilateral hippocampal sclerosis. MTS remains a controversial pathology, which requires a long term management, with an unpredictable evolution.
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