Evaluation of hippocampal infolding angle and incomplete hippocampal inversion in pediatric patients with epilepsy and febrile seizures

Acay, Mehtap Beker; Köken, Reşit; Ünlü, Ebru; Kaçar, Emre; Balçık, Çınar

doi:10.5152/dir.2017.160077

Cited by 12 publications

(13 citation statements)

References 15 publications

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“… 100 Febrile seizure, especially if recurrent, severe, and prolonged, may induce persistent alternations of hippocampal neuronal circuits in balance between excitatory and inhibitory responses as well as mesial temporal sclerosis, leading to epileptogenesis following febrile seizures. 1 , 99 , 101 , 102 Prolonged febrile seizures may also cause disruption in white matter maturation, with subsequent neuroplasticity and microstructural reorganization. 103 …”

Section: Complicationsmentioning

confidence: 99%

Febrile seizures: an overview

Leung¹,

Hon²,

Leung³

2018

DIC

178

186

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BackgroundFebrile seizures are the most common neurologic disorder in childhood. Physicians should be familiar with the proper evaluation and management of this common condition.ObjectiveTo provide an update on the current understanding, evaluation, and management of febrile seizures.MethodsA PubMed search was completed in Clinical Queries using the key terms ‘febrile convulsions’ and ‘febrile seizures’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews.ResultsFebrile seizures, with a peak incidence between 12 and 18 months of age, likely result from a vulnerability of the developing central nervous system to the effects of fever, in combination with an underlying genetic predisposition and environmental factors. The majority of febrile seizures occur within 24 hours of the onset of the fever. Febrile seizures can be simple or complex. Clinical judgment based on variable presentations must direct the diagnostic studies which are usually not necessary in the majority of cases. A lumbar puncture should be considered in children younger than 12 months of age or with suspected meningitis. Children with complex febrile seizures are at risk of subsequent epilepsy. Approximately 30–40% of children with a febrile seizure will have a recurrence during early childhood. The prognosis is favorable as the condition is usually benign and self-limiting. Intervention to stop the seizure often is unnecessary.ConclusionContinuous preventative antiepileptic therapy for the prevention of recurrent febrile seizures is not recommended. The use of intermittent anticonvulsant therapy is not routinely indicated. Antipyretics have no role in the prevention of febrile seizures.

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Section: Complicationsmentioning

confidence: 99%

Febrile seizures: an overview

Leung¹,

Hon²,

Leung³

2018

DIC

178

186

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“…Finally, after reading the full texts, 13 studies properly covered the topic, met the abovedescribed inclusion criteria, and were included in the present review. Among the abovementioned 13 studies, seven studies report information on epilepsy frequency in subjects with IHI and were selected for the estimation of the OR of epilepsy 4,14,[19][20][21][22][23] ; seven full texts were retrospective cohort studies regarding samples of subjects with MCD and hippocampal anomalies, including malrotation, 4,6,7,[24][25][26][27] and were included to calculate the prevalence of IHI in cortical malformations. One of the abovementioned articles 4 provided information about both explored outcomes, thus being included for both the estimation of OR and the prevalence of IHI in MCD.…”

Section: Identification Of Studiesmentioning

confidence: 99%

“…The final material included 13 studies: two prospective 21,22 and 11 retrospective (Tables 1 and 2). 4,6,7,14,19,20,[23][24][25][26][27] The entire population was composed of 1630 subjects. Twelve studies, involving 1356 subjects, provided information about the gender distribution, with 667 males (49.2%) and 689 females (50.8%).…”

Section: Studies Descriptionmentioning

confidence: 99%

“…Gender distribution was available in six of seven studies 4,19-23 and described a population of 765 subjects (410 epilepsy patients): 388 (50.7%) males (202 patients) and 377 (49.3%) females (208 in the epilepsy group). Two studies 19,23 enrolled children or young adults (range = 0-20 years), one study 20 involved both children and adults aged between 2 months and 75 years, and the latest four studies were restricted to adults. 4,14,21,22 With respect to epilepsy classification, three studies focused on TLE, 4,14,22 one was restricted to patients with juvenile myoclonic epilepsy, 21 two studies enrolled both patients with focal epilepsy (temporal and extratemporal) and generalized epilepsy, 20,23 and one was limited to drug-resistant focal epilepsy.…”

Section: Risk Of Epilepsy In Patients With Ihimentioning

confidence: 99%

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Incomplete hippocampal inversion and epilepsy: A systematic review and meta‐analysis

et al. 2020

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Objective Incomplete hippocampal inversion (IHI) is a relatively frequent radiological finding at visual inspection in both epilepsy and healthy controls, but its clinical significance is unclear. Here, we systematically retrieve and assess the association between epilepsy and IHI using a meta‐analytic approach. Additionally, we estimate the prevalence of IHI in patients with malformation of cortical development (MCD). Methods We systematically searched two databases (Embase and PubMed) to identify potentially eligible studies from their inception to December 2019. For inclusion, studies were population‐based, case–control, observational studies reporting on epilepsy and IHI. The risk of developing epilepsy in IHI (estimated with odds ratio [ORs]) and the frequency of IHI among patients with MCD are provided. Results We screened 3601 records and assessed eligibility of 2812 full‐text articles. The final material included 13 studies involving 1630 subjects. Seven studies (1329 subjects: 952 epileptic and 377 nonepileptic) were included for the estimation of the risk of developing epilepsy in the presence of IHI. The estimated OR of active epilepsy in IHI was 1.699 (95% confidence interval = 0.880–3.281), with moderate heterogeneity across studies (I2 = 71%). Seven studies (591 patients) provided information about the frequency of IHI in MCD. Up to one third of patients with MCD (27.9%) presented coexistent IHI. Significance The present findings confirm that IHI is commonly observed in patients with MCD especially in periventricular nodular heterotopia or polymicrogyria. However, the estimated OR indicates overall weak increased odds of epilepsy in people with IHI, suggesting that the presence of isolated IHI cannot be considered a strong independent predictor for epilepsy development. Clear‐cut neuroradiological criteria for IHI and advanced postprocessing analyses on structural magnetic resonance imaging scans are recommended to highlight differences between epileptogenic and nonepileptogenic IHI.

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“…Matsufuji et al also reported five epilepsy patients with unilateral HIMAL, and they suggested that HIMAL could have a causative role in these cases [ 27 , 28 ]. However, later studies found that HIMAL can also be observed in the normal population [ 18 , 19 , 20 , 29 ]. This brings up the possibility that HIMAL occurred by chance on the same side in these cases and was not causally related to their seizures [ 18 , 19 ].…”

Section: Epileptogenic Role Of Himalmentioning

confidence: 99%

Hippocampal Malrotation: A Genetic Developmental Anomaly Related to Epilepsy?

Lin

et al. 2021

Brain Sciences

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Hippocampal malrotation (HIMAL) is an increasingly recognized neuroimaging feature but the clinical correlation and significance in epilepsies remain under debate. It is characterized by rounded hippocampal shape, deep collateral, or occipitotemporal sulcus, and medial localization of the hippocampus. In this review, we describe the embryonic development of the hippocampus and HIMAL, the qualitative and quantitative diagnosis issues, and the pathological findings of HIMAL. HIMAL can be bilateral or unilateral and more on the left side. Furthermore, the relevance of HIMAL diagnosis in clinical practice, including its role in epileptogenesis and the impact on the pre-surgical decision are reviewed. Finally, the relationship between HIMAL and hippocampal sclerosis (HS) and the possible role of genetics in the etiology of HIMAL are discussed. The evidence so far suggested that HIMAL does not have a significant role in epileptogenesis or surgical decision. HIMAL could be a genetic developmental imaging feature that represents a more diffuse but subtle structural error during brain development. Many questions remain to be explored, such as possible cognitive alteration associated with HIMAL and whether HIMAL predisposes to the development of HS. Further studies using high-quality MRI, unified consensus qualitative and quantitative diagnostic criteria, and comprehensive cognitive assessment are recommended.

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Evaluation of hippocampal infolding angle and incomplete hippocampal inversion in pediatric patients with epilepsy and febrile seizures

Cited by 12 publications

References 15 publications

Febrile seizures: an overview

Febrile seizures: an overview

Incomplete hippocampal inversion and epilepsy: A systematic review and meta‐analysis

Hippocampal Malrotation: A Genetic Developmental Anomaly Related to Epilepsy?

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