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Hippocampal sclerosis in children younger than 2 years

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Abstract

Background

Hippocampal sclerosis (HS) is rarely considered as a diagnosis in children younger than 2 years.

Objective

To describe imaging features in conjunction with clinical information in patients with hippocampal sclerosis who are younger than 2 years.

Materials and methods

We retrospectively reviewed MR brain imaging and clinical information in five children in whom the diagnosis of HS was made both clinically and by MRI prior to 2 years of age.

Results

Imaging features establishing the diagnosis of hippocampal sclerosis were bright T2 signal and volume loss, while the internal architecture of the hippocampal formation was preserved in almost all children. Clinically, all children had an infectious trigger.

Conclusion

It is necessary for radiologists to consider HS in children with certain clinical features to plan an MRI protocol that is appropriate for detection of hippocampal pathology.

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References

  1. Téllez-Zenteno JF, Dhar R, Wiebe S (2005) Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain 128(Pt 5):1188–1198

    Article  PubMed  Google Scholar 

  2. Wiebe S, Blume WT, Girvin JP et al (2001) Effectiveness and efficiency of surgery for temporal lobe epilepsy study group. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 345:311–318

    Article  PubMed  CAS  Google Scholar 

  3. Grattan-Smith JD, Harvey AS, Desmond PM et al (1993) Hippocampal sclerosis in children with intractable temporal lobe epilepsy: detection with MR imaging. AJR 161:1045–1048

    PubMed  CAS  Google Scholar 

  4. Harvey AS, Cross JH, Shinnar S et al (2008) ILAE Pediatric Epilepsy Surgery Survey Taskforce. Defining the spectrum of international practice in pediatric epilepsy surgery patients. Epilepsia 49:146–155

    Article  PubMed  Google Scholar 

  5. Dunleavy M, Shinoda S, Schindler C et al (2010) Experimental neonatal status epilepticus and the development of temporal lobe epilepsy with unilateral hippocampal sclerosis. Am J Pathol 176:330–342

    Article  PubMed  CAS  Google Scholar 

  6. Mohamed A, Wyllie E, Ruggieri P et al (2001) Temporal lobe epilepsy due to hippocampal sclerosis in pediatric candidates for epilepsy surgery. Neurology 56:1643–1649

    PubMed  CAS  Google Scholar 

  7. Provenzale JM, Barboriak DP, VanLandingham K et al (2008) Hippocampal MRI signal hyperintensity after febrile status epilepticus is predictive of subsequent mesial temporal sclerosis. AJR 190:976–983

    Article  PubMed  Google Scholar 

  8. Sathasivam S, Nicolson A (2008) First seizure—to treat or not to treat? Int J Clin Pract 62:1920–1925

    Article  PubMed  CAS  Google Scholar 

  9. Cascino GD, Jack CR Jr, Parisi JE et al (1991) Magnetic resonance imaging-based volume studies in temporal lobe epilepsy: pathological correlations. Ann Neurol 30:31–36

    Article  PubMed  CAS  Google Scholar 

  10. Lee DH, Gao FQ, Rogers JM et al (1998) MR in temporal lobe epilepsy: analysis with pathologic confirmation. AJNR 19:19–27

    PubMed  CAS  Google Scholar 

  11. Bronen R (1998) MR of mesial temporal sclerosis: how much is enough? AJNR 19:15–18

    PubMed  CAS  Google Scholar 

  12. Scott RC, King MD, Gadian DG et al (2003) Hippocampal abnormalities after prolonged febrile convulsion: a longitudinal MRI study. Brain 126(Pt 11):2551–2557

    Article  PubMed  Google Scholar 

  13. Kim JH, Tien RD, Felsberg GJ et al (1995) Fast spin-echo MR in hippocampal sclerosis: correlation with pathology and surgery. AJNR 16:627–636

    PubMed  CAS  Google Scholar 

  14. Oppenheim C, Dormont D, Biondi A et al (1998) Loss of digitations of the hippocampal head on high-resolution fast spin-echo MR: a sign of mesial temporal sclerosis. AJNR 19:457–463

    PubMed  CAS  Google Scholar 

  15. Baldwin GN, Tsuruda JS, Maravilla KR et al (1994) The fornix in patients with seizures caused by unilateral hippocampal sclerosis: detection of unilateral volume loss on MR images. AJR 162:1185–1189

    PubMed  CAS  Google Scholar 

  16. Chan S, Erickson JK, Yoon SS (1997) Limbic system abnormalities associated with mesial temporal sclerosis: a model of chronic cerebral changes due to seizures. Radiographics 17:1095–1110

    PubMed  CAS  Google Scholar 

  17. Bronen RA (1992) Epilepsy: the role of MR imaging. AJR 159:1165–1174

    PubMed  CAS  Google Scholar 

  18. Gaillard WD, Chiron C, Cross JH et al (2009) ILAE, Committee for Neuroimaging. Subcommittee for Pediatrics. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia 50:2147–2153

    Article  PubMed  Google Scholar 

  19. Jogi DH, Patel M (2005) Mesial temporal sclerosis. Case report. SA Journal of Radiology, pp 25–27

  20. Phal PM, Usmanov A, Nesbit GM et al (2008) Qualitative comparison of 3-T and 1.5-T MRI in the evaluation of epilepsy. AJR 191:890–895

    Article  PubMed  Google Scholar 

  21. Prudent V, Kumar A, Liu S et al (2010) Human hippocampal subfields in young adults at 7.0 T: feasibility of imaging. Radiology 254:900–906

    Article  PubMed  Google Scholar 

  22. Brewer JB, Magda S, Airriess C et al (2009) Fully-automated quantification of regional brain volumes for improved detection of focal atrophy in Alzheimer disease. AJNR 30:578–580

    Article  PubMed  CAS  Google Scholar 

  23. Stanley JA, Cendes F, Dubeau F et al (1998) Proton magnetic resonance spectroscopic imaging in patients with extratemporal epilepsy. Epilepsia 39:267–273

    Article  PubMed  CAS  Google Scholar 

  24. Campos BA, Yasuda CL, Castellano G et al (2010) Proton MRS may predict AED response in patients with TLE. Epilepsia 51:783–788

    PubMed  CAS  Google Scholar 

  25. King KG, Glodzik L, Liu S et al (2008) Anteroposterior hippocampal metabolic heterogeneity: three-dimensional multivoxel proton 1H MR spectroscopic imaging—initial findings. Radiology 249:242–250

    Article  PubMed  Google Scholar 

  26. Concha L, Livy DJ, Beaulieu C et al (2010) In vivo diffusion tensor imaging and histopathology of the fimbria-fornix in temporal lobe epilepsy. J Neurosci 30:996–1002

    Article  PubMed  CAS  Google Scholar 

  27. Jayalakshmi S, Sudhakar P, Panigrahi M (2011) Role of single photon emission computed tomography in epilepsy. Int J Mol Imaging. Dec 14 [Epub ahead of print]

  28. French JA, Williamson PD, Thadani VM et al (1993) Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination. Ann Neurol 34:774–780

    Article  PubMed  CAS  Google Scholar 

  29. Spooner CG, Berkovic SF, Mitchell LA et al (2006) New-onset temporal lobe epilepsy in children: lesion on MRI predicts poor seizure outcome. Neurology 67:2147–2153

    Article  PubMed  CAS  Google Scholar 

  30. Jayalakshmi S, Panigrahi M, Kulkarni DK et al (2011) Outcome of epilepsy surgery in children after evaluation with non-invasive protocol. Neurol India 59:30–36

    Article  PubMed  Google Scholar 

  31. Scott RC (2009) Status epilepticus in the developing brain: long-term effects seen in humans. Epilepsia 50(Suppl 12):32–33

    Article  PubMed  Google Scholar 

  32. Ng YT, McGregor AL, Duane DC et al (2006) Childhood mesial temporal sclerosis. J Child Neurol 21:512–517

    PubMed  Google Scholar 

  33. Mathern GW, Adelson PD, Cahan LD et al (2002) Hippocampal neuron damage in human epilepsy: Meyer’s hypothesis revisited. Prog Brain Res 135:237–251

    Article  PubMed  Google Scholar 

  34. Theodore WH, Kelley K, Toczek MT et al (2004) Epilepsy duration, febrile seizures, and cerebral glucose metabolism. Epilepsia 45:276–279

    Article  PubMed  Google Scholar 

  35. VanLandingham KE, Heinz ER, Cavazos JE et al (1998) Magnetic resonance imaging evidence of hippocampal injury after prolonged focal febrile convulsions. Ann Neurol 43:413–426

    Article  PubMed  CAS  Google Scholar 

  36. Shinnar S, Hesdorffer DC, Nordli DR Jr et al (2008) FEBSTAT study team. Phenomenology of prolonged febrile seizures: results of the FEBSTAT study. Neurology 71:170–176

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Nadja Kadom.

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Kadom, N., Tsuchida, T. & Gaillard, W.D. Hippocampal sclerosis in children younger than 2 years. Pediatr Radiol 41, 1239–1245 (2011). https://doi.org/10.1007/s00247-011-2166-4

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  • DOI: https://doi.org/10.1007/s00247-011-2166-4

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