Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study.
Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study.
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DOI：
10.1002/ana.24081
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发表时间：
2014-02
影响因子：
11.2
通讯作者：
Sun, Shumei
中科院分区：
文献类型：
--
作者：
Lewis, Darrell V.;Shinnar, Shlomo;Hesdorffer, Dale C.;Bagiella, Emilia;Bello, Jacqueline A.;Chan, Stephen;Xu, Yuan;MacFall, James;Gomes, William A.;Moshe, Solomon L.;Mathern, Gary W.;Pellock, John M.;Nordli, Douglas R., Jr.;Frank, L. Matthew;Provenzale, James;Shinnar, Ruth C.;Epstein, Leon G.;Masur, David;Litherland, Claire;Sun, Shumei
长期以来，关于癫痫热性持续状态（FSE）是否导致海马硬化（HS）和颞叶癫痫（TLE）一直存在争议。我们的目标是确定FSE是否会导致急性海马损伤并发展为HS。FEBSTAT和两项附属研究前瞻性招募了226名1个月至6岁的FSE儿童和单纯热性惊厥对照儿童。所有患者均进行了急性MRI，大多数患者在大约1年后进行了随访MRI。视觉解释由两名神经放射科医生只告知受试者的年龄增加了海马体积，分析海马内分布的T2信号，和表观扩散系数。海马T2高信号，最大的索默的部门，发生急性FSE后，在226名儿童与体积增加。在22例急性T2高信号患者中，14例患者的随访MRI显示10例HS，12例海马体积缩小。相比之下，116名无急性高信号的儿童随访显示，仅1名（另一次FSE发作后）T2信号异常。此外，与单纯热性惊厥对照组相比，急性MRI正常的FSE受试者的右海马体积比异常低，最初的海马体积比较小，海马生长减少。FSE后海马T2高信号表示急性损伤，通常在一年后演变为HS的放射学表现。此外，FSE后正常海马的生长受损表明即使在没有T2高信号的情况下也存在轻微损伤。需要更长时间的随访来确定这些发现与TLE的关系。
Whether febrile status epilepticus (FSE) produces hippocampal sclerosis (HS) and temporal lobe epilepsy (TLE) has long been debated. Our objective is to determine if FSE produces acute hippocampal injury that evolves to HS. FEBSTAT and two affiliated studies prospectively recruited 226 children aged 1 month to 6 years with FSE and controls with simple febrile seizures. All had acute MRIs and follow-up MRIs were obtained at approximately 1 year later in the majority. Visual interpretation by two neuroradiologists informed only of subject age was augmented by hippocampal volumetrics, analysis of the intra-hippocampal distribution of T2 signal, and apparent diffusion coefficients. Hippocampal T2 hyperintensity, maximum in Sommer's sector, occurred acutely after FSE in 22 of 226 children in association with increased volume. Follow-up MRIs obtained on 14 of the 22 with acute T2 hyperintensity showed HS in 10 and reduced hippocampal volume in 12. In contrast, follow-up of 116 children without acute hyperintensity showed abnormal T2 signal in only 1 (following another episode of FSE). Furthermore, compared to controls with simple febrile seizures, FSE subjects with normal acute MRIs had abnormally low right to left hippocampal volume ratios, smaller hippocampi initially and reduced hippocampal growth. Hippocampal T2 hyperintensity after FSE represents acute injury often evolving to a radiological appearance of HS after one year. Furthermore, impaired growth of normal appearing hippocampi after FSE suggests subtle injury even in the absence of T2 hyperintensity. Longer follow-up is needed to determine the relationship of these findings to TLE.
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影响因子：
11
作者：
Bower, SPC;Kilpatrick, CJ;Cook, MJ
通讯作者：
Cook, MJ
影响因子：
11.2
作者：
Hesdorffer, Dale C.;Benn, Emma K. T.;Bagiella, Emilia;Nordli, Douglas;Pellock, John;Hinton, Veronica;Shinnar, Shlomo
通讯作者：
Shinnar, Shlomo
影响因子：
9.9
作者：
Nordli, Douglas R., Jr.;Moshe, Solomon L.;Sun, Shumei
通讯作者：
Sun, Shumei
影响因子：
5
作者：
Provenzale, James M.;Barboriak, Daniel P.;Lewis, Darrell V.
通讯作者：
Lewis, Darrell V.
影响因子：
2.8
作者：
Farina, L;Bergqvist, C;Bilaniuk, LT
通讯作者：
Bilaniuk, LT