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Febrile seizures and mesial temporal sclerosis

No association in a long-term follow-up study

From the Departments of Pediatrics (Drs. Tarkka, Uhari, and Rantala) and Diagnostic Radiology (Drs. Pääkkö and Pyhtinen), University of Oulu, Finland.

Address correspondence and reprint requests to Dr. Heikki Rantala, Department of Pediatrics, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland; e-mail: Heikki.Rantala{at}oulu.fi

Objective: To determine whether febrile seizures cause mesial temporal sclerosis (MTS), the occurrence of MTS was evaluated in an unselected series of patients with febrile seizures.

Methods: Twenty-four patients with a prolonged first febrile seizure, 8 with an unprovoked seizure after the first febrile seizure, and 32 age-, sex-, and handedness-matched control subjects with a single simple febrile seizure without later unprovoked seizures were selected from 329 febrile seizure patients followed up prospectively. The occurrence of MTS was evaluated after a mean follow-up time of 12.3 years by MR volumetry of amygdala and hippocampal formation and qualitative analysis of mesial temporal structures.

Results: None of the patients had MTS. The mean total volumes of the right and left hippocampal formations and amygdala did not differ significantly between any of the three groups. The qualitative analysis revealed no sclerotic changes in the mesial temporal area. The patients with a prolonged initial febrile seizure had a lower mean right–left volume difference in hippocampal formations than the control subjects, but this had no effect on the outcome.

Conclusion: The occurrence of MTS following even prolonged febrile seizures is an uncommon event, confirming the good clinical outcome of febrile seizures.

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