Hippocampal sclerosis: cause or consequence of febrile seizures

Retrospective studies of patients who underwent surgery for refractory temporal lobe epilepsy found a relation between history of early febrile seizures, hippocampal sclerosis, and the development of temporal lobe epilepsy.1 Previous MRI studies have reported smaller volumes of the amygdala and the hippocampus in patients with prolonged febrile seizures in childhood than in those without such a history2 suggesting that early febrile seizures are a precipitating event that leads to hippocampal sclerosis. In prospective studies, early febrile seizures or other brain injuries rarely lead to hippocampal sclerosis and temporal lobe epilepsy.3Although epidemiological studies have not yet corroborated the “surgical” correlations, there is convincing evidence that children with complicated febrile seizures have a higher risk for development of temporal lobe epilepsy. The precise pathophysiological relation, however, between febrile seizures, hippocampal sclerosis, and temporal lobe …