The pathology of HS deserves special mention at this point. It remains a point of controversy as to whether HS is the underlying cause, or end result of the clinical syndrome of MTLE. As a cause, the proposed theories underlying HS include childhood febrile convulsions, perinatal hypoxic events or vascular accidents, whereas as an end result it is suggested repeated seizures progressively inflict end-organ damage, particularly in the susceptible areas of the hippocampus described earlier. In a molecular biological sense, a causative action would allow quantification of gene expression changes of each cell type whereas as an outcome, genomic profiling would be representative of changes in cell population.