Chapter 17 - The Role of Febrile Convulsions in Mesial Temporal Sclerosis

Abstract

This chapter discusses the role of febrile convulsions in mesial temporal sclerosis (MTS). MTS is a pathological term used to describe gliosis and loss of neurons within the hippocampus, subiculum, parahippocampal gyrus, amygdala, and inferomedial temporal cortex. MTS is recognized as the most common pathological finding in adults with temporal lobe epilepsy (TLE), reported as the sole pathology in approximately 65% of adults with TLE who undergo temporal lobectomy with en bloc resection of the medial structures. The possible association between TLE and febrile seizures has prompted extensive clinical research, most studies following cohorts of children with febrile seizures. Quantitative magnetic resonance (MR) analysis with hippocampal volumetry and T2-relaxometry has been used to examine the association between MTS and febrile seizures. It is suggested that prolonged febrile seizures may cause hippocampal injury in the immature brain, and that this might lead to the development of MTS and subsequent TLE. The possibility of preexisting temporal lobe lesions predisposing to prolonged febrile seizures in infancy, and in conjunction with the resultant MTS, the development of later TLE is also elaborated.