Auer Tibor, Barsi Peter, Bone Beata, Angyalosi Anna, Aradi Mihaly, Szalay Csaba, Horvath Reka A, Kovacs Norbert, Kotek Gyula, Fogarasi Andras, Komoly Samuel, Janszky Imre, Schwarcz Attila, Janszky József
Department of Neurology, University of Pécs, Pécs, Hungary.
Epilepsia. 2008 Sep;49(9):1562-9. doi: 10.1111/j.1528-1167.2008.01679.x. Epub 2008 May 21.
It is unclear whether the hippocampal abnormality in temporal lobe epilepsy (TLE) is a consequence or the cause of afebrile or febrile seizures (FSs). We investigated whether hippocampal abnormalities are present in healthy adults>15 years after a simple FS.
Eight healthy subjects (5 men) with a history of simple FS (FS+ group) and eight sex- and aged-matched control subjects (FS- group) were investigated by three MR methods: blinded visual inspection of the MRI pictures; automatic voxel-based volumetry; and T2 relaxation time measurements.
The mean total volume of the two hippocampi was 5.36 +/- 1.33 cm(3)in the FS+ group and 6.63 +/- 1.46 cm(3)in the FS- group (p = 0.069). The T2 values in the anterior part of the left hippocampus (p = 0.036) and in the middle part of the right hippocampus (p = 0.025) were elevated in the FS+ subjects. The mean volume of the right hippocampus was 3.05 +/- 0.8 cm(3)in the FS+ men and 4.05 +/- 0.48 cm(3)in the FS- men (p = 0.043). The mean total volume of the two hippocampi was 5.38 +/- 1.4 cm(3)in the FS+ men and 7.48 +/- 1.14 cm(3)in the FS- men (p = 0.043). There were three FS+ men in whom hippocampal abnormalities including hippocampal sclerosis (HS) and dysgenesis were observed on visual inspection.
A history of simple FS in childhood can be associated with hippocampal abnormalities in adults. These abnormalities are probably more pronounced in men. Simple FS may not be as a benign event as previously thought. Our findings suggest that hippocampal abnormalities associated with FS are not necessarily epileptogenic.
摘要 背景：目前尚不清楚颞叶癫痫（TLE）患者海马体异常是无热惊厥或热性惊厥（FS）的结果还是原因。我们研究了在单纯性FS发作超过15年后的健康成年人中是否存在海马体异常。
采用三种磁共振成像方法对8名有单纯性FS病史的健康受试者（5名男性，FS+组）和8名性别及年龄匹配的对照受试者（FS-组）进行研究：对MRI图像进行盲法视觉检查；基于体素的自动容积测量；以及T2弛豫时间测量。
FS+组双侧海马体的平均总体积为5.36±1.33 cm³，FS-组为6.63±1.46 cm³（p = 0.069）。FS+组受试者左侧海马体前部（p = 0.036）和右侧海马体中部（p = 0.025）的T2值升高。FS+组男性右侧海马体的平均体积为3.05±0.8 cm³，FS-组男性为4.05±0.48 cm³（p = 0.043）。FS+组男性双侧海马体的平均总体积为5.38±1.4 cm³，FS-组男性为7.48±1.14 cm³（p = 0.043）。在视觉检查中，有3名FS+组男性观察到包括海马硬化（HS）和发育异常在内的海马体异常。
儿童时期的单纯性FS病史可能与成年人的海马体异常有关。这些异常在男性中可能更为明显。单纯性FS可能并不像之前认为的那样是良性事件。我们的研究结果表明，与FS相关的海马体异常不一定具有致痫性。
