The clinic and Magnetic resonance imaging diagnostic in patients with temporal lobe epilepsy by hippocampal sclerosis_Journal of Epilepsy

Authors：

 DANG Lianrong

Department of Radiology, the Third People’s Hospital of Tianshui City, Gansu Province, Tianshui 741000, China;

Corresponding?author：

DANG Lianrong, Email: tsdlr@126.com

Keywords：

Hippocampal sclerosis; Epilepsy; Magnetic resonance imaging

DOI：

10.7507/2096-0247.202203005

Video：

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Objective The research goal: to study the diagnostic value of T2-flair sequence of magnetic resonance imaging (MRI) in hippocampal sclerosis. Methods The clinical data of 135 patients with epilepsy caused by hippocampal sclerosis in the Epilepsy Center of Tianshui Third People's Hospital from March 2019 to December 2020 were analyzed retrospectively, studying the correlation between the changes of hippocampal sclerosis signal and the frequency of epileptic seizures in MRI T2-flair sequence multi axial scanning. Results There were 109 cases of simple hippocampal sclerosis and 26 cases of hippocampal sclerosis with other lesions, including 8 cases of cavernous hemangioma, 9 cases of traumatic or infectious malacia, 2 cases of focal cortical dysplasia, 1 case of cerebral fissure malformation, 1 case of giant gyrus and 5 cases of perinatal brain injury. MRI features of hippocampal sclerosis were as follows: ① hippocampal volume increased slightly, structure blurred, and T2-flair showed slightly increased hippocampal signal in 15 cases, accounting for 11.11%; ② The hippocampal formation was fuzzy, T2-flair was punctate hyperintense, and the volume did not change in 17 cases (12.59%); ③ Hippocampal pyknosis into small lumps, T2-flair sequence showed high signal in 103 cases, accounting for 76.30%. Statistics showed that there was a correlation between hippocampal sclerosis signal and seizure frequency (χ²=94.94, P<0.05). The higher the hippocampal sclerosis signal, the more the seizure frequency. Conclusion MRI T2-flair sequence multi axial scanning can improve the diagnostic accuracy of hippocampal sclerosis. As the change of hippocampal sclerosis signal becomes more obvious, the trend of seizure frequency increases.

Citation： DANG Lianrong. The clinic and Magnetic resonance imaging diagnostic in patients with temporal lobe epilepsy by hippocampal sclerosis. Journal of Epilepsy, 2022, 8(4): 316-319. doi: 10.7507/2096-0247.202203005 Copy

1.	徐冬梅, 苗建軍. 520例兒童癲癇與高熱驚厥的關系分析. 神經疾病與精神衛生, 2003, 3(2): 131-132.
2.	Harvey As, Grattan-Smith JD, Desmond PM, et al. Febrile seizures and hippocampal sclerosis: frequent and related findings in intractable temporal lobe epilepsy of childhood. Pediatr Neurol, 1995, 12(3): 201.
3.	French JA, Williamson PD, Thadani VM, et al. Characteristics of medial temporal lobe epilepsy: results of history and physical examination. Ann Neurol, 1993, 34(6): 774.
4.	Epstein LG, Shinnar S, Hesdorffer DC, et al. Human herpesvirus 6 and 7 in febrile status epilepticus: the FEBSTAT study. Epilepsia, 2012, 53(9): 1481-1488.
5.	黨連榮. 腦室周圍白質軟化癥的CT征象分析. 中國臨床醫學影像雜志, 2015, 26(9): 612-615.
6.	黨連榮, 裴慧杰, 王文娟, 等. 3. 0T磁共振對癲癇患者顱腦檢查診斷分析. 甘肅醫藥, 2021, 40(8): 729-731.
7.	Mueller SG, Laxer KD, Schuff N, et al. Voxel-based T₂ relaxation rate measurements in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis. Epilepsia, 2007, 48: 220-228.
8.	張一瑋, 有慧, 馮逢. 顳葉癲癇伴海馬硬化MRI診斷研究進展. 國際醫學放射學雜志, 2017, 40(5): 528-531.
9.	關樂, 盧潔, 曹燕翔, 等. 海馬硬化致顳葉癲癇的SPECT與MRI研究. 中國現代神經疾病雜志, 2015, 15(11): 870-874.
10.	顏有霞, 梁長虹, 黃飚, 等. 海馬硬化的MRI及¹H-MRS研究. 放射學實踐, 2008, 23(1): 17-19.
11.	Chan S, Bello JA, Shinnar S, et al. Hippocampal malrotation is associated with prolonged febrile seizuers: results of the FEBSTAT study. Am J Roentgenol, 2015, 205(5): 1068-1074.
12.	Koyama R. Findings from FEBSTAT study. Nihon Yakurigaku Zasshi, 2015, 146(1): 66.
13.	Lewis D, Hesdorffer D, Moshe SL, et al. Reply: to PMID 24318290. Ann Neurol, 2014, 76(2): 316-317.
14.	王煥明, 胡飛, 陳俊, 等. 海馬硬化型顳葉癲癇的外科治療--附42例報告. 癲癇雜志, 2019, 5(3): 182-186.
15.	Cherian A, Radhakrishnan A, Parameswaran S, et al. Do sphenoidal electrodes aid in surgical decision making in drug resistant temporal lobe epilepsy? Chin Neurophysiol, 2012, 123: 463-470.
16.	楊濤, 程景良, 張艷, 等. 彌散加權成像和表觀彌散系數值對顱內囊性病變鑒別的價值. 中華放射學雜志, 2004, 38: 1277-1280.
17.	韋勇, 肖恩華. 兒童熱性驚厥海馬MRI的研究進展. 中華腦科疾病與康復雜志(電子版), 2016, 6(2): 116-119.
18.	高枚春, 陸欽池. 顳葉癲癇海馬硬化的影像學診斷. 神經病學與神經康復學雜志, 2009, 6(1): 81-85.
19.	Briellmann RS, Pell GS, Wellard RM, et al. MR imaging of epilepsy: state of the art at 1. 5T and potential of 3T. Epileptic Disord, 2003, 5(1): 3-20.

1. 徐冬梅, 苗建軍. 520例兒童癲癇與高熱驚厥的關系分析. 神經疾病與精神衛生, 2003, 3(2): 131-132.
2. Harvey As, Grattan-Smith JD, Desmond PM, et al. Febrile seizures and hippocampal sclerosis: frequent and related findings in intractable temporal lobe epilepsy of childhood. Pediatr Neurol, 1995, 12(3): 201.
3. French JA, Williamson PD, Thadani VM, et al. Characteristics of medial temporal lobe epilepsy: results of history and physical examination. Ann Neurol, 1993, 34(6): 774.
4. Epstein LG, Shinnar S, Hesdorffer DC, et al. Human herpesvirus 6 and 7 in febrile status epilepticus: the FEBSTAT study. Epilepsia, 2012, 53(9): 1481-1488.
5. 黨連榮. 腦室周圍白質軟化癥的CT征象分析. 中國臨床醫學影像雜志, 2015, 26(9): 612-615.
6. 黨連榮, 裴慧杰, 王文娟, 等. 3. 0T磁共振對癲癇患者顱腦檢查診斷分析. 甘肅醫藥, 2021, 40(8): 729-731.
7. Mueller SG, Laxer KD, Schuff N, et al. Voxel-based T₂ relaxation rate measurements in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis. Epilepsia, 2007, 48: 220-228.
8. 張一瑋, 有慧, 馮逢. 顳葉癲癇伴海馬硬化MRI診斷研究進展. 國際醫學放射學雜志, 2017, 40(5): 528-531.
9. 關樂, 盧潔, 曹燕翔, 等. 海馬硬化致顳葉癲癇的SPECT與MRI研究. 中國現代神經疾病雜志, 2015, 15(11): 870-874.
10. 顏有霞, 梁長虹, 黃飚, 等. 海馬硬化的MRI及¹H-MRS研究. 放射學實踐, 2008, 23(1): 17-19.
11. Chan S, Bello JA, Shinnar S, et al. Hippocampal malrotation is associated with prolonged febrile seizuers: results of the FEBSTAT study. Am J Roentgenol, 2015, 205(5): 1068-1074.
12. Koyama R. Findings from FEBSTAT study. Nihon Yakurigaku Zasshi, 2015, 146(1): 66.
13. Lewis D, Hesdorffer D, Moshe SL, et al. Reply: to PMID 24318290. Ann Neurol, 2014, 76(2): 316-317.
14. 王煥明, 胡飛, 陳俊, 等. 海馬硬化型顳葉癲癇的外科治療--附42例報告. 癲癇雜志, 2019, 5(3): 182-186.
15. Cherian A, Radhakrishnan A, Parameswaran S, et al. Do sphenoidal electrodes aid in surgical decision making in drug resistant temporal lobe epilepsy? Chin Neurophysiol, 2012, 123: 463-470.
16. 楊濤, 程景良, 張艷, 等. 彌散加權成像和表觀彌散系數值對顱內囊性病變鑒別的價值. 中華放射學雜志, 2004, 38: 1277-1280.
17. 韋勇, 肖恩華. 兒童熱性驚厥海馬MRI的研究進展. 中華腦科疾病與康復雜志(電子版), 2016, 6(2): 116-119.
18. 高枚春, 陸欽池. 顳葉癲癇海馬硬化的影像學診斷. 神經病學與神經康復學雜志, 2009, 6(1): 81-85.
19. Briellmann RS, Pell GS, Wellard RM, et al. MR imaging of epilepsy: state of the art at 1. 5T and potential of 3T. Epileptic Disord, 2003, 5(1): 3-20.

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