misdiagnosis?

[Jayrpt]

I was diagnosed as having "mesial temporal sclerosis" 4 years ago after experiencing my first grand mal seizure. I recently had another mri done (new neurologist) and he thinks i could have a "low-grade astrocytoma," which is a tumor. however, this new neurologist didnt compare my results from previous mri because the hospital lost my first one...

I was distracted by the news at the time i went to see my neurologist and hadnt got enough info off him. it will be another month before i see a neurologist and i am curious...

does anybody know if the "mesial temporal sclerosis" and "low-grade astrocytoma" are hard to distinguish from each other? Can one easily be mistaken for the other?

(i prob sound too complicated, its just that i am a little nervous and extremely anxious to find out if i have a tumor or not.) thanks in advance for the help though!!!

[brain]

Mesial Temporal Sclerosis from eMed

Mesial temporal sclerosis is the histologic substrate found in approximately 65% of temporal lobectomy specimens obtained in connection with temporal lobe epilepsy, as demonstrated in a study performed by the National Institutes of Health in 1990.1 Mesial temporal sclerosis is the pathologic abnormality most frequently seen in temporal lobe specimens.

The hippocampus, or intralimbic gyrus, is formed by 2 cortical laminae embedded in each other: the cornu ammonis (CA), also called the hippocampus proper or Ammon horn, and the dentate gyrus. The CA can be divided into regions, or fields, depending on the appearance of pyramidal neurons.

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Low-Grade Astrocytoma from eMed

A subset of astrocytomas, because of their distinctive pathology, preclude the use of the usual 4-featured grading system. These tumors may have endothelial proliferation and marked atypia; nevertheless, they are slow growing and well circumscribed. This subset comprises juvenile pilocytic astrocytoma (JPA) and its variant a juvenile pilomyxoid astrocytoma, pleomorphic xanthoastrocytoma (PXA), and subependymal giant-cell astrocytoma (SGCA). Low-grade astrocytomas generally cause symptoms by perturbing cerebral function (eg, seizures), elevating intracranial pressure (ICP) by either mass effect or obstructing cerebrospinal fluid (CSF) pathways (ie, hydrocephalus), or causing neurologic (and sometimes endocrine) abnormalities (eg, paralysis, sensory deficits, aberrant behavior, headaches).

Infiltrating low-grade astrocytomas tend to occur in the lobes of the cerebral hemispheres, especially in the frontal lobe. Pilocytic astrocytomas may occur in the frontal, temporal, and parietal lobes and cerebellum, but they are also common in locations closer to the midline, such as the hypothalamus, thalamus, optic chiasm, and brain stem. In children, pilocytic astrocytomas have a predilection for the mesial structures of the cerebellum. PXAs also are found most commonly in the hemispheres, particularly the temporal lobes. SGCAs are found most commonly in the lateral wall of the third ventricle and almost exclusively in patients with tuberous sclerosis.

[Bernard]

Association of Human Herpesvirus-6B with Mesial Temporal Lobe Epilepsy