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Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study.

Publication ,  Journal Article
Chan, S; Bello, JA; Shinnar, S; Hesdorffer, DC; Lewis, DV; MacFall, J; Shinnar, RC; Gomes, W; Litherland, C; Xu, Y; Nordli, DR; Pellock, JM ...
Published in: AJR Am J Roentgenol
November 2015

OBJECTIVE: Hippocampal malrotation is characterized by incomplete hippocampal inversion with a rounded shape and blurred internal architecture. There is still debate about whether hippocampal malrotation has pathologic significance. We present findings from the Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) study on the frequency of and risk factors for hippocampal malrotation. SUBJECTS AND METHODS: FEBSTAT is a prospective multicenter study investigating the consequences of febrile status epilepticus in childhood. MRI studies of 226 patients with febrile status epilepticus were analyzed visually by two board-certified neuroradiologists blinded to clinical details and were compared with MRI studies of 96 subjects with first simple febrile seizure. Quantitative analysis of hippocampal volume was performed by two independent observers. RESULTS: Hippocampal malrotation was present in 20 of 226 (8.8%) patients with febrile status epilepticus compared with two of 96 (2.1%) control subjects (odds ratio [OR], 4.56; 95% CI, 1.05-19.92). Hippocampal malrotation was exclusively left-sided in 18 of 22 (81.8%) patients and bilateral in the remaining four patients (18.2%). There was no case of exclusively right-sided hippocampal malrotation. Hippocampal malrotation was more common in boys than in girls (OR, 6.1; 95% CI, 1.7-21.5). On quantitative volumetric MRI analysis, the left hippocampal volume was smaller in patients with hippocampal malrotation than in control subjects with simple febrile seizure (p = 0.004), and the right-to-left hippocampal volume ratio was higher in the hippocampal malrotation group than in the simple febrile seizure group (p < 0.001). CONCLUSION: Hippocampal malrotation is a developmental malformation that predominantly affects the left hippocampus in male patients and is more frequently found in children with prolonged febrile status epilepticus than in control subjects. These data provide further evidence that hippocampal malrotation represents a pathologic error in brain development rather than a normal variant.

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

November 2015

Volume

205

Issue

5

Start / End Page

1068 / 1074

Location

United States

Related Subject Headings

  • Torsion Abnormality
  • Status Epilepticus
  • Seizures, Febrile
  • Risk Factors
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging
  • Infant
  • Image Interpretation, Computer-Assisted
 

Citation

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Chicago
ICMJE
MLA
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Chan, S., Bello, J. A., Shinnar, S., Hesdorffer, D. C., Lewis, D. V., MacFall, J., … FEBSTAT Study Team, . (2015). Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study. AJR Am J Roentgenol, 205(5), 1068–1074. https://doi.org/10.2214/AJR.14.13330
Chan, Stephen, Jacqueline A. Bello, Shlomo Shinnar, Dale C. Hesdorffer, Darrell V. Lewis, James MacFall, Ruth C. Shinnar, et al. “Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study.AJR Am J Roentgenol 205, no. 5 (November 2015): 1068–74. https://doi.org/10.2214/AJR.14.13330.
Chan S, Bello JA, Shinnar S, Hesdorffer DC, Lewis DV, MacFall J, et al. Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study. AJR Am J Roentgenol. 2015 Nov;205(5):1068–74.
Chan, Stephen, et al. “Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study.AJR Am J Roentgenol, vol. 205, no. 5, Nov. 2015, pp. 1068–74. Pubmed, doi:10.2214/AJR.14.13330.
Chan S, Bello JA, Shinnar S, Hesdorffer DC, Lewis DV, MacFall J, Shinnar RC, Gomes W, Litherland C, Xu Y, Nordli DR, Pellock JM, Frank LM, Moshé SL, Sun S, FEBSTAT Study Team. Hippocampal Malrotation Is Associated With Prolonged Febrile Seizures: Results of the FEBSTAT Study. AJR Am J Roentgenol. 2015 Nov;205(5):1068–1074.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

November 2015

Volume

205

Issue

5

Start / End Page

1068 / 1074

Location

United States

Related Subject Headings

  • Torsion Abnormality
  • Status Epilepticus
  • Seizures, Febrile
  • Risk Factors
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging
  • Infant
  • Image Interpretation, Computer-Assisted