PROTON SPECTROSCOPY IN CHILDREN WITH EPILEPSY AND FEBRILE CONVULSIONS

An association between complex febrile convulsions and the development of hippocampal atrophy, which is characterized by neuron loss and gli osis, has been suggested but is still controversial. In proton magneti c resonance spectroscopy (IH-MRS) a reduction in N-acetylaspartate (NA A), a neuron marker, or in its ratio to other metabolites, that is, cr eatine and phospocreatine (Cr) and choline-containing compounds (Cho), is considered a sensitive method for detecting neuron loss. We perfor med H-1-MRS of mesial temporal regions, including hippocampi, in two d ifferent groups of children with epilepsy: in children with a history of complex febrile convulsions (CFCs) (n = 7; mean age 7.1 years) and in children without any history of CFCs, referred to herein as the non -CFC group (n = 6; mean age 7.6 years). Changes in the metabolite rati os were detected in 57% of children in the CFC group and in 67% of chi ldren in the non-CFC group. In both groups, NAA/(Cho + Cr), NAA/Cho, a nd NAA/Cr were significantly decreased ipsilaterally to the seizure fo cus when compared with the control group, but no significant differenc es were detected between the CFC and non-CFC groups. Also on the contr alateral side, NAA/(Cho + Cr) and NAA/Cr were significantly decreased in both patient groups, but the differences were not significant betwe en the CFC and non-CFC groups. Metabolite abnormalities in the mesial temporal region were detected in children with intractable epilepsy an d in children whose epilepsy is well controlled by antiepileptic medic ation. The noninvasive H-1-MRS can be considered an additional diagnos tic method to promote early detection of mesial temporal abnormalities that, in the light of this study, seem to be underdiagnosed in childr en,vith either temporal lobe epilepsy or other seizure types. (C) 1998 by Elsevier Science Inc. All rights reserved.