Hippocampal developmental changes in patients with partial epilepsy:: Magnetic resonance imaging and clinical aspects
Hippocampal developmental changes in patients with partial epilepsy:: Magnetic resonance imaging and clinical aspects
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DOI：
10.1002/ana.410440213
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发表时间：
1998-08-01
影响因子：
11.2
通讯作者：
Berger, B
中科院分区：
文献类型：
--
作者：
Baulac, M;De Grissac, N;Berger, B
海马结构（HF）的发育障碍已被描述为与无脑回相关的癫痫综合征，但HF畸形可以发现没有广泛的皮质变化。我们报告了19名患有部分癫痫且磁共振成像（MRI）显示异常HF模式的患者。这些改变包括不完全性折叠伴脉络膜裂内侧位置异常、球形和/或垂直化，艾德在以下三种情况：（1）弥漫性神经元移行障碍（n = 1），（2）颞叶畸形（n = 5），包括异位、异常旋转和2例HF体积减少;（3）明显孤立性HF改变（n = 13，双侧3例）。临床特征是异质性的癫痫的严重程度，当可以确定的重点，在本地化（颞或颞外）。在4例明显孤立的HF改变的患者中，MRI提示发育异常和海马硬化。术前及术后检查均提示多个致痫灶，其中2例累及额叶。一个HF样本足够大，可以观察到与MRI上观察到的变化相对应的发育异常。HF的形状和/或位置变化应包括在与部分癫痫相关的结构异常中。它们可能代表了更广泛或更遥远的大脑发育障碍的可见部分。
Developmental disorders of the hippocampal formation (HF) have been described in epileptic syndromes associated with lissencephaly, but HF malformations can be found without widespread cortical changes. We report 19 patients with partial epilepsy and abnormal HF patterns on magnetic resonance imaging (MRI). The changes consisted of incomplete folding with abnormal medial location along the choroid fissure, globular shape and/or verticalization, and were observed ed in the following three contexts: (1) diffuse disorder of neuronal migration (n = 1); (2) temporal lobe malformation (n = 5), including heterotopia, abnormal gyration, and, in 2 cases, reduced HF volume; and (3) apparently isolated HF changes (n = 13, bilateral in 3 cases). The clinical features were heterogeneous in terms of severity of epilepsy and, when the focus could be determined, in localization (temporal or extratemporal). In 4 patients with apparently isolated HF changes, MRI was suggestive of both abnormal development and hippocampal sclerosis. In these patients, presurgical investigation and postoperative results suggested multiple epileptogenic foci, involving the frontal lobes in 2 cases. One HF specimen was large enough for the observation of developmental abnormalities corresponding to the changes seen on MRI. HF changes in shape and/or position should be included among the structural abnormalities associated with partial epilepsies. They may represent the visible part of a more extensive or more distant disorder of brain development.