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Hippocampal asymmetries and white matter abnormalities on MRI in benign childhood epilepsy with centrotemporal spikes
S Lundberg1, O Eeg-Olofsson, R Raininko
1Department of Women's and Children's Health, Uppsala University, Sweden.
Insights
Magnetic resonance imaging (MRI) detected hippocampal asymmetries and white-matter abnormalities in children with benign childhood epilepsy with centrotemporal spikes (BCECTS). These findings, previously undetectable, may indicate maturational delays or myelination defects.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Epileptology
Background:
- Benign childhood epilepsy with centrotemporal spikes (BCECTS) is the most common epilepsy syndrome in children.
- Previous neuroimaging studies have not consistently identified brain abnormalities in BCECTS patients.
Purpose of the Study:
- To investigate brain abnormalities using magnetic resonance imaging (MRI) in children diagnosed with BCECTS.
- To identify potential structural or signal changes associated with this common childhood epilepsy syndrome.
Main Methods:
- MRI scans were performed on eighteen children (aged 6-12 years) with typical BCECTS.
- Six children underwent a second MRI examination for longitudinal assessment.
- Analysis focused on identifying hippocampal abnormalities and white-matter signal changes.
Main Results:
- Hippocampal abnormalities were observed in 33% of children, including size asymmetry (28%) and T2-weighted hyperintensities (17%).
- White-matter abnormalities, specifically T2-weighted hyperintensities near the cortex-white matter junction, were found in 28% of patients.
- Eight children (44%) had normal MRI findings; two presented with additional non-epilepsy-related malformations.
Conclusions:
- Hippocampal asymmetries and white-matter abnormalities are detectable with MRI in typical BCECTS.
- The etiology of hippocampal asymmetry remains unclear, while white-matter changes may suggest maturational delays or myelination defects.
- Further long-term studies are necessary to correlate these MRI findings with the clinical progression of BCECTS.
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.
