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Published on: August 5, 2014
Hippocampal damage in newly diagnosed focal epilepsy: a prospective MRI study
T Salmenperä1, M Könönen, N Roberts
1Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
Objective:
To examine the longitudinal appearance of hippocampal (HC) damage in a prospective follow-up study of patients with newly diagnosed epilepsy.
Methods:
A total of 103 patients with newly diagnosed focal epilepsy were scanned with MRI before antiepileptic medication was started. Serial MRI studies were scheduled after 1, 2 to 3, and 5 years of treatment in the ongoing follow-up study. Volumes of the HC were measured from MRI scans according to the Cavalieri method of modern design stereology and compared at different time points together with clinical variables.
Results:
No difference was observed in the mean HC volumes between controls and patients at baseline, after 1, 2 to 3, and 5 years of follow-up. Individual analysis showed that 8% of patients had HC damage at the time of the diagnosis and 13% of patients developed HC volume decrease during 2 to 3 years of follow-up. These patients had longer duration of seizure disorder and larger seizure number before the epilepsy was diagnosed and treatment started compared with patients who did not show HC damage.
Conclusions:
Hippocampal volume decreases occur in individual patients with newly diagnosed focal epilepsy during the first years of treatment. The data obtained suggest that hippocampal volumetry provides a surrogate marker of the epileptic process.
