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NEUROLOGY 1993;43:1083
© 1993 American Academy of Neurology

Early childhood prolonged febrile convulsions, atrophy and sclerosis of mesial structures, and temporal lobe epilepsy

An MRI volumetric study

F. Cendes, MD, F. Andermann, MD, FRCP(C), F. Dubeau, MD, FRCP(C), P. Gloor, MD, PhD, A. Evans, PhD, M. Jones-Gotman, PhD, A. Olivier, MD, PhD, FRCS(C), E. Andermann, MD, PhD, Y. Robitaille, MD, I. Lopes-Cendes, MD, T. Peters, PhD and D. Melanson, MD

Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada.

We performed MRI volumetric measurements of the amygdala (AM) and hippocampal formation (HF) in a group of 43 patients with temporal lobe epilepsy not controlled by optimal drug treatment. Fifteen patients (35%) had a history of prolonged febrile convulsions (PFC) in early childhood; 30 patients underwent surgery, and histopathology was available in twenty-four. The mean values of AM and HF volumes ipsilateral to the EEG focus were significantly smaller than those of normal controls. The volumetric measurements showed a more pronounced atrophy of the AM in patients with a history of PFC, although the HF volumes were also smaller in this group. Patients with a history of PFC had a higher proportion of more severe mesial temporal sclerosis (MTS) compared with those with no PFC. These findings confirm a correlation between early childhood PFC, the severity of atrophy of mesial structures, and MTS.

Address correspondence and reprint requests to Dr. Frederick Andermann, Montreal Neurological Hospital and Institute, 3801 University St., Montreal, PQ, Canada H3A 2B4.

Received July 14, 1992. Accepted for publication in final from October 26, 1992.




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