J Korean Neurol Assoc.
2000 Nov;18(6):694-699.
Hippocampal Atrophy Pattern and Hippocampal Volume in Mesial Temporal Sclerosis: Correlation with Risk Factors and Surgical Outcome
- Affiliations
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- 1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine.
- 2Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine.
- 3Department of Neuroradiology, Asan Medical Center, University of Ulsan College of Medicine.
Abstract
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BACKGROUND: Hippocampal sclerosis (HS) is the most common cause of temporal lobe epilepsy (TLE). However, the regional distribution pattern and volume loss of HS and its clinical significance are still controversial. We investigated the regional distribution of hippocampal atrophy (HA) and the volume loss of HS and correlated these data with several clinical factors including seizure risk factor and surgical outcome.
METHODS
MRI volumetry was performed on 40 patients with TLE and pathologically proven HS and 20 control subjects using PACS system. The patterns of HA were categorized into diffuse and regional types. The clinical factors included were : age at onset, seizure duration, sex, history of febrile convulsion, and meningoencephalitis. MR volumetry data representing volume loss and pattern of HA were analyzed looking at surgical outcome and clinical factors.
RESULTS
1) The MRI volumetry of hippocampus was highly sensitive and specific (above 95%) for HS. 2) Diffuse HA involving both the hippocampal head and body was slightly more common (56%) than the regional pattern. Regional atrophy was usually found in the hippocampal body. 3) The history of meningitis/encephalitis was significantly associated with diffuse atrophy (p=0.034). 4) The age at seizure onset was correlated with the degree of HA (r=0.460, p=0.003). 5) The pattern and severity of HA were not related to surgical outcome.
CONCLUSIONS
The variable patterns of HA exist in mesial temporal sclerosis. They may be related to various clinical factors and the underlying epileptogenic process.
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