ObjectiveTo study the cytokine changes in the cerebrospinal fluid (CSF) of mesial temporal lobe epilepsy (MTLE) patients, and the mechanism of the development of hippocampal sclerosis. MethodsFifty MTLE patients who sought treatment from January 2013 to March 2014 were included in the study. Clinical features were investigated. All CSF samples of the 59 patients along with 19 samples of the control group were tested for 12 common cytokines using a chemokine magnetic bead panel. Data were statistically analyzed. ResultsClinical features showed no significant difference between hippocampal sclerosis and non-hippocampal sclerosis patients. Interleukin (IL)-1 receptor antagonist (RA), IL-4 and IL-9 expression decreased, and tumor necrosis factor (TNF)-α, IL-3 and IL-5 expression increased. Up-regulation of TNF-α was significantly different between hippocampal sclerosis and non-hippocampal sclerosis patients. ConclusionIL-1RA, IL-3, IL-4, IL-5 and IL-9 changes may be non-specific seizure-related cytokine regulation. TNF-α is associated with hippocampal sclerosis pathology. TNF-α is a possible pathological element in hippocampal sclerosis development.