Febrile seizures and mesial temporal sclerosis
Febrile seizures and mesial temporal sclerosis
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DOI：
10.1097/00019052-200404000-00013
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发表时间：
2004-04-01
影响因子：
4.8
通讯作者：
Cendes, F
中科院分区：
文献类型：
--
作者：
Cendes, F
回顾发热性癫痫继发顽固性颞叶癫痫的顺序从人群的角度来看是很少见的。然而，几项研究表明，儿童早期长期发热性癫痫发作史与内侧颞叶硬化症之间存在显著关系。对这些观察结果的解释仍然存在相当大的争议。一种可能性是，早期高热发作损害了海马体，因此是内侧颞叶硬化症的原因之一。另一种可能性是，孩子有长期的发热性癫痫，因为海马体以前曾被产前或围产期的侮辱或遗传易感性破坏。最近的研究结果成像研究表明，长期的局灶性发热性癫痫发作可导致急性海马区损伤，并演变为海马体萎缩，在一些儿童中，复杂的发热性癫痫发作可能起源于颞叶。现在有几条证据表明，遗传易感性是热性惊厥和内侧颞叶硬化症的重要原因。最近的临床和分子遗传学研究表明，热性惊厥和后来的癫痫之间的关系往往是遗传的，并且有几个热性惊厥的证候特异性基因。大量的回顾性研究表明，复杂的热性惊厥是导致内侧颞叶硬化症和颞叶癫痫后期发展的一个因素。然而，几项前瞻性和回溯性研究得出了相互矛盾的结果。高热惊厥和颞叶癫痫之间的联系可能是几个遗传和环境因素之间复杂的相互作用的结果。
Purpose of review The sequence of febrile seizures followed by intractable temporal lobe epilepsy is rarely seen from a population perspective. However, several studies have shown a significant relationship between a history of prolonged febrile seizures in early childhood and mesial temporal sclerosis. The interpretation of these observations remains quite controversial. One possibility is that the early febrile seizure damages the hippocampus and is therefore a cause of mesial temporal sclerosis. Another possibility is that the child has a prolonged febrile seizure because the hippocampus was previously damaged by a prenatal or perinatal insult or by genetic predisposition.Recent findings Imaging studies have shown that prolonged and focal febrile seizures can produce acute hippocampal injury that evolves to hippocampal atrophy, and that complex febrile seizures can originate in the temporal lobes in some children. Several lines of evidence now indicate that genetic predisposition is an important causal factor of febrile seizures and mesial temporal sclerosis. From recent clinical and molecular genetic studies, it appears that the relationship between febrile seizures and later epilepsy is frequently genetic, and there are several syndrome-specific genes for febrile seizures.Summary Mesial temporal sclerosis probably has different causes. A number of retrospective studies showed that complex febrile seizures are a causative factor for the later development of mesial temporal sclerosis and temporal lobe epilepsy. However, contradictory results have come from several prospective and retrospective studies. The association between febrile seizures and temporal lobe epilepsy probably results from complex interactions between several genetic and environmental factors.