Magnetic Resonance Imaging Evidence of Hippocampal Sclerosis in Progression: A Case Report

Virinder Nohria, Namsoo Lee, Robert D. Tien, E. Ralph Heinz, Jean S. Smith, G. Robert DeLong, Mark B. Skeen, Trevor J. Resnick, Barbara Crain, Darrell V. Lewis

Research output: Contribution to journalArticlepeer-review

112 Scopus citations

Abstract

Summary: A 32‐month‐old child presented in status epilepticus (SE) involving the left side of the body. Fast spin‐echo magnetic resonance imaging (FSE‐MRI) with hippocampal volumetry performed ≤24 h after the seizure showed increased T2 signal of the right hippocampus, but no atrophy. Complex partial seizures (CPS) appeared at age 33 months, and three more episodes of SE occurred between 33 and 37 months of age. Follow‐up FSE‐MRI at 34 and at 45 months of age demonstrated progressive hippocampal atrophy with resolution of the increased T2 signal. Her CPS became intractable and, at age 51 months, she underwent right temporal lobectomy. In the ensuing 5 months, she has had only one major motor seizure. This case demonstrates that acute increased hippocampal T2 signal intensity can occur soon after SE and hippocampal sclerosis (HS) may become evident within months in the setting of recurrent early childhood SE. This observation may support the hypothesis that early childhood SE can lead to HS. Furthermore, this case suggests that years of temporal lobe CPS may not be necessary for development of HS.

Original languageEnglish (US)
Pages (from-to)1332-1336
Number of pages5
JournalEpilepsia
Volume35
Issue number6
DOIs
StatePublished - Nov 1994

Keywords

  • Complex partial seizures
  • Hippocampal sclerosis
  • Magnetic resonance imaging
  • Status epilepticus
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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