FDG-PET and MRI in temporal lobe epilepsy: relationship to febrile seizures, hippocampal sclerosis and outcome

Salanova, Vicenta; Markand, Omkar N.; Worth, Robert M.; Smith, R. D.; Wellman, Henry N.; Hutchins, Gary D.; Park, H.; Ghetti, Bernardino; Azzarelli, Biagio

doi:10.1111/j.1600-0404.1998.tb00628.x

Cited by 62 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hippocampal sclerosis is found in about 70% of TLE patients [Babb and Brown, 1987;Wolf et al, 1993] and its presence is predictive of a favorable seizure outcome after surgery [Arruda et al, 1996;Jutila et al, 2002;Salanova et al, 1998]. Mesial TLE is typically associated with predominantly unilateral anterior and infero-medial temporal epileptic abnormalities on scalp EEG and hippocampal atrophy on MRI [Engel et al, 1997;Jackson et al, 2005;Wieser et al, 1993].…”

Section: Introductionmentioning

confidence: 99%

Temporal lobe epilepsy: Differential pattern of damage in temporopolar cortex and white matter

Sankar

Bernasconi

Kim

et al. 2008

Human Brain Mapping

View full text Add to dashboard Cite

Our purpose was to quantify structural changes of the temporopolar cortex (TPC) and its white matter (TPWM) in temporal lobe epilepsy (TLE) using MRI volumetry and texture analysis. We studied 23 patients with hippocampal atrophy, and 20 healthy controls. Gradient magnitude and entropy were calculated to model signal intensity blurring on T1-MRI. Two observers assessed signal changes and atrophy visually. Compared to controls, TLE patients had a decrease in TPC and TPWM volume ipsilateral to the seizure focus. The gradient magnitude and entropy were decreased ipsilateral to the focus only in TPWM, indicating blurring of this compartment. Eighty-seven percent of TLE patients had at least one volumetric or textural abnormality. Although sensitivity of visual and quantitative assessment of TPC atrophy was comparable (43 and 39%), specificity was higher for volumetry (54% vs. 95%). Compared to visual analysis of signal changes in TPWM on T1-MRI, texture metrics had higher sensitivity (65% vs. 17%) and specificity (100% vs. 69%). The proportion of patients with blurring of TPWM as determined by texture analysis was higher than that seen on visual inspection of T2 images (78% vs. 43%). We found no clear association between volumetric or textural changes of TPC and TPWM and outcome after surgery. Structural changes of the anatomically distinct TPC and TPWM are found ipsilateral to the seizure focus in the majority of TLE patients with hippocampal sclerosis. MRI post-processing allows dissociating different pathological tissue characteristics and shows that atrophy involves gray and white matter, whereas blurring is confined to white matter. Hum Brain

show abstract

Section: Introductionmentioning

confidence: 99%

Temporal lobe epilepsy: Differential pattern of damage in temporopolar cortex and white matter

Sankar

Bernasconi

Kim

et al. 2008

Human Brain Mapping

View full text Add to dashboard Cite

show abstract

“…About 50-60% of pediatric patients, being treated for temporal lobe epilepsy, present not only with HS but also with a history of febrile seizures [14]. In this context, it is possible that our patient currently resides in a "silent" period, which may be followed by temporal lobe epilepsy as a sequel.…”

Section: Discussionmentioning

confidence: 96%

Cerebral hemiatrophy associated with hippocampal sclerosis following a single prolonged febrile seizure

et al. 2011

View full text Add to dashboard Cite

The etiological relation of prolonged febrile seizures with hippocampal sclerosis and cerebral hemiatrophy is controversial. Causal relationship is mainly adopted from retrospective statistical analysis and data from epilepsy surgery. We report a 17-month-old boy who had a prolonged febrile seizure with a transient postictal flaccid hemiparesis and anisocoria. Family history was unremarkable. Magnetic resonance imaging (MRI) revealed abnormal results in the right hippocampal area where diffusion-weighted sequences showed increased signal intensity consistent with acute neuronal edema. Repeat MRI 5 months later demonstrated sclerosis and atrophy of the right hippocampus in association with an increased T2-weighted signal and atrophy of the right frontal, temporal, and parietal lobe. In addition, 18-fluorodeoxyglucose positron emission tomography and 99mTc-ECD single-photon emission computed tomography revealed glucose hypometabolism and decreased perfusion in the right hemisphere, respectively. A final MRI, 12 months following the seizure, was widely unchanged. Interestingly, during a follow-up of 42 weeks, only minor motor deficits were observed. This case uniquely presents the acute onset of hippocampal sclerosis and, consecutively, cerebral hemiatrophy after a single febrile seizure. This suggests that a single prolonged febrile seizure may cause global morphological changes of the brain, not only affecting hippocampal formation.

show abstract

“…About 50-60% of pediatric patients being treated for temporal lobe epilepsy (TLE) present both: HS and a history of febrile seizures [11]. Linkage analyses lead to the identification of a genetic locus on chromosome 4p for familial temporal lobe epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Development of hippocampal sclerosis after a complex febrile seizure

Merkenschlager

Todt

Pfluger³

et al. 2008

Eur J Pediatr

View full text Add to dashboard Cite

The role of prolonged febrile seizures in the genesis of hippocampal sclerosis is controversial; statistical analysis and data from epilepsy surgery suggest a causal relationship. A three-year-old boy had an initial febrile seizure with a transient postictal flaccid hemiparesis. Magnetic resonance imaging (MRI) showed no abnormality of the hippocampal areas of both sides. At the age of four a prolonged febrile seizure occurred. An MRI was done immediately and gave abnormal results in the right hippocampal area where T2-weighted and dark fluid sequences showed increased signal intensity; in diffusion-weighted sequences this region appeared hyperintense, which is in agreement with acute neuronal damage. Six weeks later the right hippocampal region still gave hyperintense signals in MRI (T2-weighted), while the diffusion coefficient was unremarkable. A final MRI scan was done 16 months following the second febrile seizure where the right hippocampal region still gave hyperintense signals and was reduced in size as is typical for hippocampal sclerosis. This case illustrates the development of a hippocampal lesion following a prolonged focal febrile seizure without any preexisting hippocampal lesion or positive family history. This suggests that prolonged febrile seizures alone can be a causative factor of hippocampal sclerosis.

show abstract

FDG-PET and MRI in temporal lobe epilepsy: relationship to febrile seizures, hippocampal sclerosis and outcome

Cited by 62 publications

References 29 publications

Temporal lobe epilepsy: Differential pattern of damage in temporopolar cortex and white matter

Temporal lobe epilepsy: Differential pattern of damage in temporopolar cortex and white matter

Cerebral hemiatrophy associated with hippocampal sclerosis following a single prolonged febrile seizure

Development of hippocampal sclerosis after a complex febrile seizure

Contact Info

Product

Resources

About