Predictors of Hippocampal, Cerebral and Cerebellar Volume Reduction in Childhood Epilepsy
Abstract number :
3.073
Submission category :
Year :
2000
Submission ID :
3310
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
John A Lawson, Simon Vogrin, Andrew F Bleasel, McAnally Laraine, Mark J Cook, Ann M.E Bye, Sydney Children's Hosp, Randwick, Australia; St Vincents Hosp, Melbourne, Australia; New Children's Hosp, Westmead, Australia.
RATIONALE: We examined the factors related to brain volume reduction in a paediatric sample that included nonintractable epilepsy. METHODS: Entry criteria were children <18 years with epilepsy referred for MRI scan including a whole brain volumetric sequence. The sample size was 231. Risk factors were ascertained from interview and review of medical records. Factors included age of onset, seizure years (szyrs), family history, status epilepticus (SE), intellectual disability (ID) and febrile convulsions (FC). MRI data was obtained on 44 normal childhood controls. RESULTS: Cerebral and cerebellar volume was significantly associated with age, gender, moderate to severe ID (p<0.001), szyrs and SE (p<0.03). Compared to controls, brain volume of all patients was reduced by 10% (p<0.001). Hippocampal volume (HV) was significantly associated with total brain volume, age (p<0.001), focal cerebral ischaemic injury and complex FC (p<0.05). CONCLUSIONS:Significant brain volume reduction is present in children with epilepsy. A component of this reduction is due to acquired insults. The reduction is seen even in children with infrequent seizures over a brief time suggesting an innate structural abnormality. When evaluating possible aetiologic factors in the development of HV reduction (HVR), one must control for TBV. We have confirmed the association of complex FC with unilateral HVR. _