Longitudinal Quantitative Hippocampal Magnetic Resonance Imaging Study of Adults with Newly Diagnosed Partial Seizures: One-Year Follow-Up Results
Corresponding Author
W. Van Paesschen
Epilepsy Research Group, London. U.K.
NMR Unit, Great Ormond Street Hospital for Children and Institute of Child Health, London. U.K.
Address correspondence and reprint requests to Dr. W. Van Paesschen at Department of Neurology, University Hospital Gasthuis-berg, 49 Herestraat, 3000 Leuven, Belgium.Search for more papers by this authorJ. M. Stevens
Department of Neuroradiology, University Department of Clinical Neurology, National Hospital for Neurology and Neurosurgery, London. U.K.
Search for more papers by this authorA. Connelly
NMR Unit, Great Ormond Street Hospital for Children and Institute of Child Health, London. U.K.
Search for more papers by this authorCorresponding Author
W. Van Paesschen
Epilepsy Research Group, London. U.K.
NMR Unit, Great Ormond Street Hospital for Children and Institute of Child Health, London. U.K.
Address correspondence and reprint requests to Dr. W. Van Paesschen at Department of Neurology, University Hospital Gasthuis-berg, 49 Herestraat, 3000 Leuven, Belgium.Search for more papers by this authorJ. M. Stevens
Department of Neuroradiology, University Department of Clinical Neurology, National Hospital for Neurology and Neurosurgery, London. U.K.
Search for more papers by this authorA. Connelly
NMR Unit, Great Ormond Street Hospital for Children and Institute of Child Health, London. U.K.
Search for more papers by this authorAbstract
Summary: Purpose: We wished to establish whether hippocampal changes occur in 1 year in adults with newly diagnosed partial seizures and, if so, to identify possible causes and mechanisms.
Methods: Thirty-six adult patients with newly diagnosed partial seizures underwent a magnetic resonance imaging (MRI) scan of the brain including hippocampal volume and T, relaxation time (HCT2) measurement and had a follow-up quantitative MRI scan ∼1 year after the baseline MRI scan.
Results: At baseline, 4 patients (11%) had hippocampal sclerosis (HS), 4 (11%) had abnormalities other than HS, and 28 had a normal MRI scan (78%). Twenty-three patients (64%) had recurrent seizures in the period between the two MRI scans. One of the 4 patients with HS, who had daily seizures, had significantly increased HCT2 values on follow-up, possibly reflecting progressive hippocampal damage. None of the 32 patients with MRI findings other than HS at baseline progressed to HS on follow-up. However, 2 of the 32 patients had significant hippocampal changes, probably related to resolution of inflammatory swelling or edema after seizures were controlled.
Conclusions: Subtle changes in hippocampi can occur in 1 year in adults with newly diagnosed partial seizures, which could be due to resolution of edema after seizure control or to hippocampal changes associated with frequent and daily seizures. Follow-up of the studied cohort for several years will be required to settle the question of whether progressive hippocampal damage occurs in temporal lobe epilepsy (TLE).
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