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Fieberkrämpfe und mesiale Temporallappenepilepsie

Febrile seizures and mesiotemporal epilepsy

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Zusammenfassung

Die initiale Manifestation von Temporallappenepilepsie mit Fieberkrämpfen ist eine seit Langem bekannte klinische Assoziation. Wiederholt wurde aus der zeitlichen Sequenz eine kausale Rolle der Fieberkrämpfe als primäre hippokampale Schädigung gefolgert, aus der sich dann eine mesiale Temporallappenepilepsie entwickelt. Im Folgenden wird anhand von Aspekten epidemiologischer Assoziationen, tierexperimenteller und genetischer Befunde sowie Analysen aus Imaging-Studien und des epilepsiechirurgischen Outcome die Frage kritisch diskutiert, welche Evidenz für eine Rolle von Fieberkrämpfen als initialem Pathomechanismus besteht. Es wird argumentiert, dass die Lateralität der Hippokampussklerose Hinweise auf eine präexistente unilaterale Schädigung vor Manifestation fiebergetriggerter Anfälle gibt.

Abstract

The early manifestation of temporal lobe epilepsy with febrile seizures is a well-known clinical association. From the sequence, it was repeatedly derived that febrile seizures play a causal role for the primary hippocampal damage, from which mesiotemporal epilepsy then develops. Epidemiological, experimental data, as well as genetic, imaging and surgical outcome data are discussed regarding the evidence for febrile seizures as the initial precipitating injury. It is argued that the laterality of hippocampal sclerosis points towards a pre-existing unilateral pathology at the time the fever-triggered seizures occurred.

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  1. Epilepsiezentrum, Universitätsklinikum Freiburg, Breisacher Str. 64, 79106, Freiburg, Deutschland

    A. Schulze-Bonhage

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  1. A. Schulze-Bonhage
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Correspondence to A. Schulze-Bonhage.

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Schulze-Bonhage, A. Fieberkrämpfe und mesiale Temporallappenepilepsie. Z. Epileptol. 22, 225–230 (2009). https://doi.org/10.1007/s10309-009-0065-6

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