Epilepsy and amygdalar enlargement: cause or consequence?

The amygdala is a central structure of the limbic system. For several decades, volumetric asymmetries of the amygdala have been described, initially associated with psychiatric disorders. In epilepsy, a growing literature highlights the distinctive features of amygdala enlargement (AE), considering that since its original description, diagnosis has been primarily radiological. The objective of the present work is to demonstrate, through reviews of existing academic publications and through our experience, that its function goes beyond imaging, contemplating a defined clinical, electrographic, and histopathological pattern that responds to both medical and surgical treatment. Therefore, it would be an entity that extends beyond a reactive phenomenon. In conclusion, AE would be a specific syndrome defined with particular characteristics that extends beyond a reactive mechanism secondary to adjacent epileptogenic networks.