Artículos de revistas
Magnetic Resonance Imaging Evidence Of Hippocampal Sclerosis In Asymptomatic, First-degree Relatives Of Patients With Familial Mesial Temporal Lobe Epilepsy
Registro en:
Archives Of Neurology. , v. 59, n. 12, p. 1891 - 1894, 2002.
39942
10.1001/archneur.59.12.1891
2-s2.0-0036894830
Autor
Kobayashi E.
Li L.M.
Lopes-Cendes I.
Cendes F.
Institución
Resumen
Objective: To investigate the presence of hippocampal atrophy (HA) and other magnetic resonance imaging (MRI) signs of hippocampal sclerosis (HS) in asymptomatic relatives of patients with familial mesial temporal lobe epilepsy (FMTLE). Methods: We invited first-degree, asymptomatic relatives of patients with FMTLE to participate in our MRI protocol. After obtaining informed consent, all participating individuals underwent an MRI examination. Hippocampal abnormality was determined by qualitative and volumetric analyses, using a standard protocol. Results: We studied 52 asymptomatic individuals (27 men), with a mean age of 32 years (range, 7-71 years), from 11 families with FMTLE. Volumetric studies showed HA in 18 (34%) of 52 individuals: 11 had left HA and 7 had bilateral HA. In addition, careful visual analysis of T1- and T2-weighted images showed additional classic MRI signs of HS (such as abnormal T2 signal and/or abnormal internal structure) in 14 of these 18 individuals. There was no age difference between individuals with and without HA (t test, P=.80). Conclusions: Our findings indicate that MRI evidence of HS is not necessarily related to seizure severity and may occur in individuals who never had seizures. In addition, these observations strongly indicate that HS in FMTLE is not a consequence of recurrent seizures and is determined by a strong genetic predisposition. The determination of seizure severity in patients with FMTLE probably depends on the interaction of different factors, both genetic and environmental. 59 12 1891 1894 Kobayashi, E., Sousa, S.C., Lopes-Cendes, I., Guerreiro, C.A.M., Guerreiro, M.M., Cendes, F., Seizure outcome and hippocampal atrophy in familial mesial temporal lobe epilepsy (2001) Neurology, 56, pp. 166-172 Cendes, F., Lopes-Cendes, I., Andermann, E., Andermann, F., Familial temporal lobe epilepsy: A clinically heterogeneous syndrome (1998) Neurology, 50, pp. 554-557 Kobayashi, E., Andermann, F., Li, M.L., Volumetric studies in familial mesial temporal lobe epilepsy [abstract] (2001) Neurology, 56 (SUPPL.), pp. A153 Fernandez, G., Effenberger, O., Vinz, B., Hippocampal malformation as a cause of familial febrile convulsions and hippocampal sclerosis (1998) Neurology, 50, pp. 909-916 Watson, C., Jack, C.R., Cendes, F., Volumetric magnetic resonance imaging: Clinical applications and contributions to the understanding of temporal lobe epilepsy (1997) Arch Neurol, 54, pp. 1521-1531 Meencke, H.J., Veith, G., Hippocampal sclerosis in epilepsy (1991) Epilepsy Surgery, pp. 705-715. , Luders H, ed. New York, NY: Raven Press Babb, T.L., Brown, W.J., Pathological findings in epilepsy (1987) Surgical Treatment of the Epilepsies, pp. 511-540. , Engel J Jr, ed. New York, NY: Raven Press Jack C.R., Jr., Sharbrough, F.W., Cascino, G.D., Hirschorn, K.A., O'Brien, P.C., Marsh, W.R., Magnetic resonance image-based hippocampal volumetry: Correlation with outcome after temporal lobectomy (1992) Ann Neurol, 31, pp. 138-146 Cascino, G.D., Jack, C.R., Parisi, J.E., Magnetic resonance imaging-based volume studies in temporal lobe epilepsy: Pathological correlations (1991) Ann Neurol, 30, pp. 31-36 Van Paesschen, W., Connelly, A., King, M.D., Jackson, G.D., Duncan, J.S., The spectrum of hippocampal sclerosis: A quantitative magnetic resonance imaging study (1997) Ann Neurol, 41, pp. 41-51 Duvernoy, H.M., (1988) The Human Hippocampus: An Atlas of Applied Anatomy, , Munich, Germany: J F Bergman Verlag Baulac, M., De Grissac, N., Hasboun, D., Hippocampal developmental changes in patients with partial epilepsy: Magnetic resonance imaging and clinical aspects (1998) Ann Neurol, 44, pp. 223-233 Thom, M., Sisodiya, S.M., Lin, W.R., Bilateral isolated hippocampal malformation in temporal lobe epilepsy (2002) Neurology, 58, pp. 1683-1686 Curtis, M., Avanzini, G., Interictal spikes in focal epileptogenesis (2001) Prog Neurobiol, 63, pp. 541-567