A six-year follow-up MRI study of complicated early childhood convulsion
Tom F D Farrow1, Jon M Dickson, Richard A Grünewald
1Department of Academic Clinical Psychiatry, University of Sheffield, Sheffield, United Kingdom. t.f.farrow@sheffield.ac.uk
Insights
Structural brain abnormalities, including hippocampal asymmetry, are common after complicated early childhood convulsions. A 6-year follow-up revealed persistent or worsening asymmetry in most children, suggesting long-term neurological impact.
Area of Science:
- Neurology
- Pediatrics
- Neuroimaging
Background:
- A previous study found over 50% of children had brain abnormalities after a first complicated early childhood convulsion.
- Significant hippocampal asymmetry was noted, independent of edema.
Purpose of the Study:
- To assess the 6-year evolution of hippocampal pathology in children following a first complicated early childhood convulsion.
Main Methods:
- Re-imaging of 8 out of 17 original subjects using magnetic resonance imaging (MRI).
- Comparison of hippocampal asymmetry and volume between initial scans and 6-year follow-up.
Main Results:
- Three subjects showed significantly increased hippocampal asymmetry.
- Two subjects displayed a modest increase in asymmetry.
- Two subjects had persistent asymmetry, and one showed apparent resolution.
- Elevated hippocampal T2 relaxation times did not correlate with reduced hippocampal volumes.
Conclusions:
- Complicated early childhood convulsions may lead to lasting hippocampal structural changes.
- The long-term neurological consequences of these events may be underestimated.
Abstract:
We have previously reported a greater than 50% prevalence of structural brain abnormalities in children within 2 weeks of first complicated early childhood convulsion, including significant hippocampal asymmetry unrelated to edema. In a 6-year follow-up study, 8 of the original 17 subjects were reimaged to determine any developments in hippocampal pathology. Three subjects manifested significantly greater asymmetry, and two exhibited a modest increase in asymmetry at follow-up compared with that present at initial magnetic resonance imaging. Two of the remaining three subjects manifested no change in the degree of hippocampal asymmetry that was already evident at initial scan, whereas in the final case, apparent resolution of previously identified (slight) hippocampal asymmetry had occurred. Elevated hippocampal T2 relaxation times did not consistently accord with smaller hippocampal volumes. These results suggest that complicated early childhood convulsion may be less benign than often supposed.
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