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Hippocampal asymmetries and white matter abnormalities on MRI in benign childhood epilepsy with centrotemporal spikes
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
1999 (English)In: Epilepsia, ISSN 0013-9580, Vol. 40, no 12, 1808-15 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To look for brain abnormalities by using magnetic resonance imaging (MRI) in patients with benign childhood epilepsy with centrotemporal spikes (BCECTS), which is the most common epilepsy syndrome in children. METHODS: Eighteen children, aged 6-12 years, with typical BCECTS were examined with MRI, six of them twice. RESULTS: Some hippocampal abnormality was found in six (33%) of the children, all with the syndrome's typical electroencephalogram (EEG) pattern ipsilaterally. Hippocampal size asymmetry was found in five (28%) children (right side < left in two and left < right in three), and high signal intensities on T2-weighted images were found in three (17%). Two children also had other abnormalities; one had a heterotopic nodule near the contralateral frontal horn, and one had an Arnold-Chiari malformation. The hippocampal asymmetry remained unchanged in three of the children who were reexamined after 2 years. High signal intensities on T2-weighted images were seen beneath the cortex-white matter junction in the frontal and temporal lobes of five (28%) children, one of whom also had a hippocampal asymmetry. MRIs were normal in eight (44%) children. CONCLUSION: For the first time, hippocampal asymmetries and white-matter abnormalities have been detectable on the MRIs of children with typical BCECTS. The etiology of the former is unclear, whereas the latter may be a result of a maturational delay involving a defective myelination. Long-term follow-up studies are needed to evaluate the relation between these findings and the clinical course of BCECTS.

Place, publisher, year, edition, pages
1999. Vol. 40, no 12, 1808-15 p.
Keyword [en]
Children, Partial epilepsy, MRI, Hippocampus, White matter
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-91501DOI: 10.1111/j.1528-1157.1999.tb01603.xPubMedID: 10612349OAI: oai:DiVA.org:uu-91501DiVA: diva2:164261
Available from: 2004-03-29 Created: 2004-03-29 Last updated: 2010-02-03Bibliographically approved
In thesis
1. Rolandic Epilepsy: A Neuroradiological, Neuropsychological and Oromotor Study
Open this publication in new window or tab >>Rolandic Epilepsy: A Neuroradiological, Neuropsychological and Oromotor Study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Rolandic epilepsy (RE) is the most common focal epilepsy syndrome in the pediatric age group with an onset between 3 and 13 years. The syndrome is defined by electro-clinically typical features and has been considered benign according to seizure remission before the age of 16 years.

The aim of this thesis was to investigate children with typical RE with different methods and to discuss the delineation of the syndrome. Thirty-eight children, aged 6–14 years, participated in one up to four studies.

Eighteen children were investigated with MRI. Hippocampal abnormalities were found in six (33%), volume asymmetry in five (28%) and high signal intensities on T2-weighted images in three (17%). Additionally, high signal intensities in T2-weighted images were revealed subcortically in temporal and frontal lobes bilaterally in five children (28%).

The hippocampal region was evaluated metabolically using proton magnetic resonance spectroscopy (1H-MRS) in 13 children with RE and 15 matched controls. A metabolic asymmetry of the hippocampal regions was found in the patients compared to controls indicating an abnormal neuronal function.

Seventeen children with RE and 17 matched controls were investigated with a neuropsychological test battery. The RE children showed lower performance in auditory-verbal tests and in executive functions compared to controls.

Twenty RE children and 24 controls were assessed concerning their oromotor function. The RE children had greater problems concerning tongue movements including articulation. A dichotic listening test was also performed in a subgroup showing poorer results in the RE group.

A simple classification is proposed with RE ‘pure’ as the main group and the frame for this study.

In conclusion, these investigations disclosed various abnormalities in children with RE, challenging the benign concept during the active phase. It is assumed that maturational factors comprise causal mechanism to the deviant findings, which probably successively will normalize.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 80 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1332
Keyword
Pediatrics, rolandic epilepsy, children, idiopathic focal epilepsy, magnetic resonance imaging, proton magnetic resonance spectroscopy, cognition, neuropsychology, oromotor performance, dichotic listening, hippocampus, classification, Pediatrik
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-4133 (URN)91-554-5910-2 (ISBN)
Public defence
2004-04-22, Rosénsalen, Barnsjukhuset, Uppsala, 13:15
Opponent
Supervisors
Available from: 2004-03-29 Created: 2004-03-29Bibliographically approved

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