High Resolution MR Imaging and Proton MR Spectroscopy of Infants and Children with Febrile Seizures

Stephen Chan, M.D.

Columbia Presbyterian Medical Center

Funded in January, 1995: $ for 3 years
LAY SUMMARY . HYPOTHESIS . SELECTED PUBLICATIONS .

HYPOTHESIS

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Hypothesis:
1. Hippocampal abnormalities and cerebral cortical abnormalities, respectively, are more common among children with a first complex febrile seizure compared to children with a first simple febrile seizure.
2. Complex febrile seizures are associated with damage to the medial temporal lobe, whether immediate, delayed, or progressive.

Goals:
1. To test the hypothesis that mesial temporal lobe abnormalities seen on magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) are more common among children with a first complex febrile seizure than among children with a first simple febrile seizure.
2. To determine using MRI whether or not hippocampal atrophy and sclerosis develop during the study period.
3. To establish whether or not specific imaging and biochemical abnormalities detected on initial MRI and MRS examinations after a first febrile seizure are associated with a higher risk of developing hippocampal atrophy and sclerosis, i.e., mesial temporal sclerosis (MTS).

Methods:
Researchers will study all pediatric patients, age 6 months to 10 years, who present with a first febrile convulsion to the pediatric emergency room, pediatric clinics, or private practices of pediatric neurologists at CPMC. Researchers will question the parent or guardian about the child's family's medical history and obtain an informed consent for the MRI and MRS examinations. These examinations will be done within 72 hours of the initial febrile seizure.

All children will be examined in one of the researchers' two GE Signa 1.5 Tesla MR Units. The MRS examination will directly follow the MRI examination. The researchers, who will be blinded as to whether these children had simple or complex febrile seizures, will read the MRI and MRS scans. Quantitative hippocampal volumetric analysis and T2 relaxometry will be performed using interactive software programs and GE workstations. All MRI and MRS examinations will be reviewed again by the researchers to test intrarater and interrater reliability of readings and measurements.

Follow-on Funding:
R01 HD36867 from NICHHD

SELECTED PUBLICATIONS

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Hesdorffer D.C., Chan S., Hinton V., Hauser W.A., Nordli D. (1997). Are MRI abnormalities associated with functional impairment among children with a first febrile seizure? Epilepsia, 38 (Suppl 8): 129.

Chan S., Hesdorffer D.C., Nordli D. (1997). High-resolution MR imaging of infants and children with a first febrile seizure: Preliminary report from a prospective study. Radiology, 205 (Suppl): p533.