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Childhood mesial temporal sclerosis
Yu-tze Ng1, Amy L McGregor, Dawn C Duane
1Division of Child Neurology, St. Joseph's Hospital and Children's Health Center at Barrow Neurological Institute, 500 West Thomas Road, Phoenix, AZ 85013, USA. y2ng@chw.edu
Insights
Mesial temporal sclerosis is uncommon in children, affecting 0.77% of pediatric brain MRI studies. When present, it is always associated with epilepsy, often following febrile seizures.
Area of Science:
- Neurology
- Pediatric Radiology
- Epileptology
Background:
- Mesial temporal sclerosis (MTS) prevalence and clinical features in children are not well-documented.
- Pediatric epilepsy diagnosis often relies on neuroimaging, including MRI.
- Understanding MTS in pediatric populations is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the prevalence of mesial temporal sclerosis in children.
- To describe the clinical characteristics of pediatric patients diagnosed with MTS.
- To investigate the association between MTS and seizure disorders in children.
Main Methods:
- Retrospective review of brain MRI reports for children under 14 years from two tertiary institutions.
- Inclusion criteria: definite or possible mesial temporal sclerosis on MRI.
- Confirmation of MRI diagnostic criteria for MTS and detailed chart review of confirmed cases.
Main Results:
- 3,100 pediatric brain MRI reports were reviewed.
- 24 out of 26 identified cases met the MRI criteria for mesial temporal sclerosis.
- The prevalence of MTS among pediatric brain MRI studies was 0.77%.
- All identified patients presented with seizures; no incidental findings of MTS were observed.
- Four patients had a history of febrile seizures.
Conclusions:
- Mesial temporal sclerosis is an uncommon finding in children.
- MTS in pediatric patients is consistently associated with epilepsy.
- Asymptomatic MTS or MTS without a seizure disorder was not observed in this series.
- Febrile seizures may be associated with childhood-onset MTS.
Abstract:
The prevalence and clinical characteristics of mesial temporal sclerosis have not been well studied in children. All brain magnetic resonance imaging (MRI) reports of children less than 14 years of age were reviewed from two tertiary institutions. A 52-month period from one institution and a 37-month period from the other were reviewed. All reports of definite or possible mesial temporal sclerosis were noted. These patients' MRIs were then reviewed to confirm the MRI diagnostic criteria of mesial temporal sclerosis. The charts of the patients who satisfied these criteria were reviewed in detail. Three thousand one hundred brain MRI reports were reviewed. Twenty-six reports of mesial temporal sclerosis were found. Twenty-four of the 26 films satisfied the criteria of mesial temporal sclerosis by MRI after the films were reviewed. The prevalence among all pediatric brain MRI studies was 0.77%. All patients had presented with seizures, that is, there were no "incidental" findings of mesial temporal sclerosis. Four patients had a history of febrile seizures. Mesial temporal sclerosis is an uncommon finding in children, but when it occurs, it is always associated with epilepsy. Asymptomatic mesial temporal sclerosis or mesial temporal sclerosis not associated with a seizure disorder did not occur in our series. Febrile seizures can occur in association with mesial temporal sclerosis presenting in childhood.
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