MTS is the most common cause of structural epilepsy and focal seizures in the temporal lobe.

Most patients present with complex partial temporal lobe epilepsy.

Febrile seizures

The relationship, if any, of mesial temporal sclerosis with febrile seizures is controversial, made all the more difficult due to the relative insensitivity of imaging and the difficulty in establishing whether a particular seizure was truly febrile. Up to a third of patients with established refractory temporal lobe epilepsy have a history of seizures in childhood at the time of fever.

Follow up of children with febrile seizures does not demonstrate significant increased incidence of temporal lobe epilepsy.