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

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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.
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5.	党连荣. 脑室周围白质软化症的CT征象分析. 中国临床医学影像杂志, 2015, 26(9): 612-615.
6.	党连荣, 裴慧杰, 王文娟, 等. 3. 0T磁共振对癫痫患者颅脑检查诊断分析. 甘肃医药, 2021, 40(8): 729-731.
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10.	颜有霞, 梁长虹, 黄飚, 等. 海马硬化的MRI及¹H-MRS研究. 放射学实践, 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.	王焕明, 胡飞, 陈俊, 等. 海马硬化型颞叶癫痫的外科治疗--附42例报告. 癫痫杂志, 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.	杨涛, 程景良, 张艳, 等. 弥散加权成像和表观弥散系数值对颅内囊性病变鉴别的价值. 中华放射学杂志, 2004, 38: 1277-1280.
17.	韦勇, 肖恩华. 儿童热性惊厥海马MRI的研究进展. 中华脑科疾病与康复杂志(电子版), 2016, 6(2): 116-119.
18.	高枚春, 陆钦池. 颞叶癫痫海马硬化的影像学诊断. 神经病学与神经康复学杂志, 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, 苗建军. 520例儿童癫痫与高热惊厥的关系分析. 神经疾病与精神卫生, 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. 党连荣. 脑室周围白质软化症的CT征象分析. 中国临床医学影像杂志, 2015, 26(9): 612-615.
6. 党连荣, 裴慧杰, 王文娟, 等. 3. 0T磁共振对癫痫患者颅脑检查诊断分析. 甘肃医药, 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. 张一玮, 有慧, 冯逢. 颞叶癫痫伴海马硬化MRI诊断研究进展. 国际医学放射学杂志, 2017, 40(5): 528-531.
9. 关乐, 卢洁, 曹燕翔, 等. 海马硬化致颞叶癫痫的SPECT与MRI研究. 中国现代神经疾病杂志, 2015, 15(11): 870-874.
10. 颜有霞, 梁长虹, 黄飚, 等. 海马硬化的MRI及¹H-MRS研究. 放射学实践, 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. 王焕明, 胡飞, 陈俊, 等. 海马硬化型颞叶癫痫的外科治疗--附42例报告. 癫痫杂志, 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. 杨涛, 程景良, 张艳, 等. 弥散加权成像和表观弥散系数值对颅内囊性病变鉴别的价值. 中华放射学杂志, 2004, 38: 1277-1280.
17. 韦勇, 肖恩华. 儿童热性惊厥海马MRI的研究进展. 中华脑科疾病与康复杂志(电子版), 2016, 6(2): 116-119.
18. 高枚春, 陆钦池. 颞叶癫痫海马硬化的影像学诊断. 神经病学与神经康复学杂志, 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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