The histories of 67 patients with medial temporal lobe seizures controlled by temporal lobectomy at a mean age of 27 years were evaluated at Yale University and Epilepsy Center, West Haven CT; Graduate Hospital, Philadelphia; Dartmouth-Hitchcock Medical Center; and VA Center, White River Junction, VT. Forty-five (67%) had histories of febrile seizures without CNS infection before 5 years of age, and of these, 33 had complex febrile seizures which lasted longer than 30 minutes. Other risk factors included head trauma (10%), and birth trauma (3%). Mean age at onset of complex partial epilepsy was 9 years. Seizures had become progressively worse over time in 22 patients before surgery. 
COMMENT. Complex febrile seizures during infancy or early childhood are frequent antecedents of medial temporal lobe epilepsy developing in later childhood. An excellent response to surgery may be expected in adult patients with a temporal lobe epilepsy syndrome associated with a history of prolonged febrile seizures. These results confirm those reported recently from the Montreal Neurological Institute (see Ped Neur Briefs Nov 1993;7:87) and support Falconer’s original suggestion of a causal relation between febrile seizures and medial temporal sclerosis (Epilepsia 1971;12:13). Of 41 patients with adequate pathological examination and a history of febrile seizures, in the Dartmouth and Yale temporal lobe epilepsy study, 38 (93%) had mesial temporal sclerosis.