FEBRILE SEIZURES AND HIPPOCAMPAL SCLEROSIS - FREQUENT AND RELATED FINDINGS IN INTRACTABLE TEMPORAL-LOBE EPILEPSY OF CHILDHOOD

The relationship between hippocampal sclerosis, febrile seizures, and complex partial seizures in temporal lobe epilepsy continues to be the subject of great debate in the literature, Hippocampal sclerosis is r eported infrequently in young children with temporal lobe epilepsy, a factor that has supported the theory that hippocampal sclerosis develo ps in later life during the course of recurrent complex partial seizur es, In a blinded review of magnetic resonance imaging in 53 children, aged 2-17 years (mean: 10 years) with temporal lobe epilepsy, hippocam pal sclerosis was diagnosed in 30 children (57%), concordant with icta l electroencephalographic lateralization in 93% and pathologic diagnos is in all children who had undergone surgery and had hippocampal tissu e available for histologic examination, Fourteen of the children (47%) with hippocampal sclerosis were younger than 10 years of age, the you ngest being 2 years, Thirty-four children (64%) had histories of neuro logic insults prior to the onset of complex partial seizures, includin g idiopathic febrile seizures in 22, Hippocampal sclerosis was associa ted with a history of a neurologic insult prior to the onset of comple x partial seizures (P < .001) and was not associated with age at onset of temporal lobe epilepsy, age at magnetic resonance imaging, duratio n of epilepsy, or presence of secondarily generalized seizures. These findings suggest that hippocampal sclerosis is underdiagnosed in child ren and is the cause and not the consequence of temporal lobe epilepsy .