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ILAE‐Defined Epilepsy Syndromes in Children: Correlation with Quantitative MRI
Author(s) -
Lawson John A.,
Nguyen William,
Bleasel Andrew F.,
Pereira John K.,
Vogrin Simon,
Cook Mark J.,
Bye Ann M. E.
Publication year - 1998
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1998.tb01335.x
Subject(s) - epilepsy , ictal , magnetic resonance imaging , epilepsy syndromes , medicine , temporal lobe , hippocampal sclerosis , pediatrics , electroencephalography , radiology , psychiatry
Summary:Purpose : The role of quantitative magnetic resonance imaging (MRI) in evaluation of childhood epilepsy remains poorly defined, with minimal published data. Previous work from our center questioned the specificity of hippocampal asymmetry (HA) in an outpatient group whose epilepsy was defined by using clinical and interictal data only. By using childhood volunteer controls and defining epilepsy syndromes using video‐EEG monitoring, we readdressed the utility of HA in differentiating mesial temporal lobe epilepsy (M tle ) from other partial and generalized epileptic syndromes in children. Methods: Seventy children were enrolled; entry criteria were age younger than 18 years with predominant seizure type recorded on video‐EEG telemetry with volumetric MRI in all cases. Thirty healthy child volunteers had volumetric MRI. Epilepsy syndrome classification was according to ILAE. Results: Control data revealed symmetric hippocampi, mean smallernarger ratio of 0.96 (0.95–0.97,95% CI) with no gender or rightneft predominance. Overall 23% of patients had significant HA. Mean hippocampal ratio for M tle was 0.78 (95% CI, 0.70–0.86), significantly lower than controls and from all other epilepsy syndromes. HA was highly specific (85%) to the syndrome of MTLE. Other potential epileptogenic lesions were found in 27 (39%) patients, lowest yield in frontal and mesial temporal syndromes. Dual pathology was present in 10% of patients. There was no significant association between HA and risk factors. Conclusions: In this study, we found that HA in children with a well‐defined epilepsy syndrome is highly sensitive and specific for MTLE. Whether this will correlate with surgical outcome, as in adults, is the subject of ongoing study.