A C McClelland1, W A Gomes2, S Shinnar3,4,5, D C Hesdorffer6, E Bagiella7, D V Lewis8, J A Bello1, S Chan9, J MacFall10, M Chen6, J M Pellock11, D R Nordli12, L M Frank13, S L Moshé3,4,14, R C Shinnar3, S Sun15. 1. From Departments of Radiology (A.C.M., W.A.G., J.A.B.). 2. From Departments of Radiology (A.C.M., W.A.G., J.A.B.) wgomes@montefiore.org. 3. Neurology (S. Shinnar, S.L.M., R.C.S.). 4. Pediatrics (S. Shinnar, S.L.M.). 5. Epidemiology and Population Health (S. Shinnar). 6. Departments of Epidemiology (D.C.H., M.C.). 7. Department of Health Evidence and Policy (E.B.), Mount Sinai School of Medicine, New York, New York. 8. Departments of Pediatrics (Neurology) (D.V.L.). 9. Radiology (S.C.), Gertrude H. Sergievsky Center, Columbia University, New York, New York. 10. Radiology (J.M.), Duke University Medical Center, Durham, North Carolina. 11. Departments of Neurology (J.M.P.). 12. Department of Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 13. Department of Neurology (L.M.F.), Children's Hospital of The King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia. 14. Neuroscience (S.L.M.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. 15. Biostatistics (S. Sun), Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia.
Abstract
BACKGROUND AND PURPOSE: The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus. MATERIALS AND METHODS: Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn. RESULTS: Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P < .001; adjusted OR, 10.59). Multiple morphologic parameters correlated with febrile status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities. CONCLUSIONS: Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum.
BACKGROUND AND PURPOSE: The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus. MATERIALS AND METHODS: Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn. RESULTS: Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P < .001; adjusted OR, 10.59). Multiple morphologic parameters correlated with febrile status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities. CONCLUSIONS: Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum.
Authors: P Barsi; J Kenéz; D Solymosi; A Kulin; P Halász; G Rásonyi; J Janszky; A Kalóczkai; G Barcs; M Neuwirth; E Paraicz; Z Siegler; M Morvai; J Jerney; M Kassay; A Altmann Journal: Neuroradiology Date: 2000-05 Impact factor: 2.804
Authors: Darrell V Lewis; Daniel P Barboriak; James R MacFall; James M Provenzale; Teresa V Mitchell; Kevan E VanLandingham Journal: Prog Brain Res Date: 2002 Impact factor: 2.453
Authors: Dale C Hesdorffer; Shlomo Shinnar; Darrell V Lewis; Solomon L Moshé; Douglas R Nordli; John M Pellock; James MacFall; Ruth C Shinnar; David Masur; L Matthew Frank; Leon G Epstein; Claire Litherland; Syndi Seinfeld; Jacqueline A Bello; Stephen Chan; Emilia Bagiella; Shumei Sun Journal: Epilepsia Date: 2012-06-28 Impact factor: 5.864
Authors: S Lehéricy; D Dormont; F Sémah; S Clémenceau; O Granat; C Marsault; M Baulac Journal: AJNR Am J Neuroradiol Date: 1995-04 Impact factor: 3.825
Authors: Céline M Dubé; Jun-Li Zhou; Mark Hamamura; Qian Zhao; Alex Ring; Jennifer Abrahams; Katherine McIntyre; Orhan Nalcioglu; Tatiana Shatskih; Tallie Z Baram; Gregory L Holmes Journal: Exp Neurol Date: 2008-10-22 Impact factor: 5.330