Hippocampal atrophy, epilepsy duration, and febrile seizures in patients with partial seizures.

Abstract:

BACKGROUND:Previous studies have suggested a variety of factors that may be associated with the presence of hippocampal formation (HF) atrophy in patients with complex partial seizures (CPS), including a history of complex or prolonged febrile seizures (FS), age at seizure onset, and epilepsy duration. OBJECTIVE:To determine whether epilepsy duration is related to HF atrophy. METHODS:We performed MRIs on 35 patients with uncontrolled CPS who had temporal lobe ictal onset on video-EEG. None had evidence for an alien tissue lesion or extra-hippocampal seizure onset. All had a history of secondary generalization. Brain structures were drawn on consecutive images and pixel points summed from successive pictures to calculate volumes. RESULTS:Nine patients with a history of complex or prolonged FS had smaller ipsilateral HF volume and ipsilateral/contralateral ratio than did patients without a history of FS. Epilepsy duration had a significant relation to ipsilateral HF volume and ipsilateral/contralateral ratio. In a multivariate analysis, the effect of duration, but not age at onset or scan, was significant. Patients with a history of FS did not have earlier age at epilepsy onset or longer duration. CONCLUSIONS:A history of FS predicted the severity of HF atrophy in our patients. Age at onset or study was not a significant factor. Epilepsy duration, however, did have a significant effect, suggesting that, after an initial insult, progressive HF damage may occur in patients with persistent seizures.

journal_name

Neurology

journal_title

Neurology

authors

Theodore WH,Bhatia S,Hatta J,Fazilat S,DeCarli C,Bookheimer SY,Gaillard WD

doi

10.1212/wnl.52.1.132

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

132-6

issue

1

eissn

0028-3878

issn

1526-632X

journal_volume

52

pub_type

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