Mesial temporal sclerosis is a specific pattern of hippocampal neuron cell loss. There are 3 specific patterns of cell loss; Cell loss might involve sectors CA1 an CA4, CA4 alone, or CA1 to CA4 . Associated hippocampal atrophy and gliosis is common. MRI scan commonly displays increased T2 signal and hippocampal atrophy Mesial temporal sclerosis might occur with other temporal lobe abnormalities (dual pathology) . Mesial temporal sclerosis is the most common pathological abnormality in temporal lobe epilepsy.