2021 Volume 37 Issue 1 Pages 55-60
Neuroimaging has an important role in the diagnosis of underlying disorders and seizure focus in childhood epilepsy. In mesial temporal lobe epilepsy (MTLE), MRI shows hippocampal atrophy and hyperintense signal that are called hippocampal sclerosis. Recent high-resolution images reveal internal structural abnormality in the hippocampus. Many patients with MTLE have febrile status epilepticus (FSE) during infancy. We have revealed hippocampal enlargement and high intense signal on diffusion-weighted images during the acute period after FSE, and subsequent hippocampal atrophy. Hippocampal enlargement and DWI high intensity suggest cytotoxic edema caused by FSE.
MRI shows thick cortex, blurred cortical-subcortical junction, and subcortical high intensity at the site of focal cortical dysplasia. However, these findings are often difficult to detect during the infantile period because of incomplete myelination.
New MRI techniques such as diffusion tensor imaging or simultaneous recording of electroencephalogram and functional MRI (EEG-fMRI) are promising tools to reveal the pathophysiology and epilepsy focus in childhood epilepsy.
