Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • McClelland, AC; Gomes, WA; Shinnar, S; Hesdorffer, DC; Bagiella, E; Lewis, DV; Bello, JA; Chan, S; MacFall, J; Chen, M; Pellock, JM; Nordli, DR; Frank, LM; Moshé, SL; Shinnar, RC; Sun, S; FEBSTAT Study Team,

Published Date

  • December 2016

Published In

Volume / Issue

  • 37 / 12

Start / End Page

  • 2356 - 2362

PubMed ID

  • 27633809

Pubmed Central ID

  • 27633809

Electronic International Standard Serial Number (EISSN)

  • 1936-959X

International Standard Serial Number (ISSN)

  • 0195-6108

Digital Object Identifier (DOI)

  • 10.3174/ajnr.A4919

Language

  • eng