Hippocampal Sclerosis in a Two-Year-Old with Temporal Lobe Epilepsy: Case Report with Pathological Confirmation

Kanos, Charles; Davies, Keith G.; O’Brien, Thomas F.; Dohan, F. C.

doi:10.1159/000028960

“…Four articles were found with a number of patient that varied from 10 to 34 as it is shown in Table 1, 2-5 and more 7 articles where MTS was diagnosed before five years old. [6][7][8][9][10][11][12] The semiology of the febrile seizure is described in Table 2. The automatisms were subtle to moderate in children and more pronounced in adolescents.…”

Section: Resultsmentioning

confidence: 99%

Clinic feature of the mesial temporal sclerosis in children

Brandão¹,

Manreza²

2007

J. epilepsy clin. neurophysiol.

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INTRODUCTION: Mesial temporal sclerosis is not a frequent cause of refractory epilepsy in children, and the its start age is uncertain. OBJECTIVE: To understand the clinic feature of children with mesial temporal sclerosis diagnosis. MATERIAL AND METHODS: It was done a literature review about this pathology in children, and it has been found a group of 4 articles that allow a general view about mesial temporal sclerosis in children and other group of 7 articles (case reports or small series) in which mesial temporal sclerosis was diagnosed until five years old. RESULTS: It was evaluated in the first group, febrile seizure that was the most frequent antecedent followed by a status epilepticus and the semiology of the seizures was characterized by oroalimentary automatism, gestural automatism, stunted movement and motor phenomenon.The group of children with mesial temporal sclerosis until five years old stood out due to the high incidence of status epilepticus (84,6%), by the number of children with altered neuropsycomotor development (46%), and by lesion in most of bilateral cases (53,8%) , suggesting that the bilateral form of the mesial temporal sclerosis might be a distinct pathology, and not necessarily the progression of a unilateral beginning picture. Another important thing to stand out in this group is the documentation by MR in edema in hippocampus after a status epilepticus and posterior atrophy of this structure. CONCLUSION: mesial temporal sclerosis can to appear still in early life and in any cases can to present an evolutional character and dependent from a previous aggression to the hippocampus.

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“…The most commonly found injury in adults is mesial temporal sclerosis (MTS) 2,3 . In children with temporal lobe epilepsy, MTS is considered an infrequent etiology 4,5 , but with the advances in neuroimaging, MTS which was thought to be a disease of adults, started to be diagnosed at an increasingly younger age [6][7][8][9] . The aim of this study was to evaluate the clinical, electrographic and radiologic MTS spectrum in children and establishing the differences as compared to manifestations observed in adults.…”

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confidence: 99%

16 Mesial Temporal Sclerosis in Children

Çataltepe¹,

Jallo²

2010

Pediatric Epilepsy Surgery: Preoperative Assessment and Surgical Treatment

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-Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. Objective: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. Method: Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine. Results: Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with the first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures. Conclusion: Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.KEY WORDS: temporal lobe epilepsy, child, adolescent, sclerosis, hippocampus. Esclerose mesial temporal em criançasRESUMO -Em adultos, esclerose mesial temporal é a causa mais freqüente de epilepsia do lobo temporal intratável por medicamentos e que responde satisfatoriamente a cirurgia, sendo considerada pouco freqüen-te em criança. Objetivo: Avaliar o espectro clínico, eletrográfico e radiológico desta patologia em crianças. Método: Estudo retrospectivo, por revisão de prontuário de 44 crianças com diagnóstico de esclerose mesial temporal na ressonância magnética, atendidos no Hospital das Clínicas da Faculdade de Medicina de São Paulo. Resultado: Foi identificado que 54% dos pacientes apresentaram antecedente de crise febril. Lesão no lado esquerdo predominou nos pacientes com dificuldade escolar (p=0.049), naqueles com primeiras crises entre seis meses e cinco anos (p=0,021) e naqueles com crise febril complicada (p=0,032). Treze pacientes foram operados, dos quais oito ficaram livres de crises. Conclusão: Crise febril pode estar relacionada de uma forma mais direta à presença de esclerose mesial temporal no lado esquerdo. PALAVRAS-CHAVE: epilepsia do lobo temporal, criança, adolescente, esclerose, hipocampo.

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“…In children with temporal lobe epilepsy, MTS is considered an infrequent etiology 4,5 , but with the advances in neuroimaging, MTS which was thought to be a disease of adults, started to be diagnosed at an increasingly younger age [6][7][8][9] .…”

mentioning

confidence: 99%

Mesial temporal sclerosis in children

Brandão

¹

,

Manreza

²

2007

Arq. Neuro-Psiquiatr.

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-Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. Objective: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. Method: Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine. Results: Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with the first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures. Conclusion: Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.KEY WORDS: temporal lobe epilepsy, child, adolescent, sclerosis, hippocampus. Esclerose mesial temporal em criançasRESUMO -Em adultos, esclerose mesial temporal é a causa mais freqüente de epilepsia do lobo temporal intratável por medicamentos e que responde satisfatoriamente a cirurgia, sendo considerada pouco freqüen-te em criança. Objetivo: Avaliar o espectro clínico, eletrográfico e radiológico desta patologia em crianças. Método: Estudo retrospectivo, por revisão de prontuário de 44 crianças com diagnóstico de esclerose mesial temporal na ressonância magnética, atendidos no Hospital das Clínicas da Faculdade de Medicina de São Paulo. Resultado: Foi identificado que 54% dos pacientes apresentaram antecedente de crise febril. Lesão no lado esquerdo predominou nos pacientes com dificuldade escolar (p=0.049), naqueles com primeiras crises entre seis meses e cinco anos (p=0,021) e naqueles com crise febril complicada (p=0,032). Treze pacientes foram operados, dos quais oito ficaram livres de crises. Conclusão: Crise febril pode estar relacionada de uma forma mais direta à presença de esclerose mesial temporal no lado esquerdo. PALAVRAS-CHAVE: epilepsia do lobo temporal, criança, adolescente, esclerose, hipocampo.

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Hippocampal Sclerosis in a Two-Year-Old with Temporal Lobe Epilepsy: Case Report with Pathological Confirmation

Cited by 4 publications

References 43 publications

Clinic feature of the mesial temporal sclerosis in children

Clinic feature of the mesial temporal sclerosis in children

16 Mesial Temporal Sclerosis in Children

Mesial temporal sclerosis in children

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