A comparative evaluation of bilateral hippocampus and amygdala volumes with ADC values in pediatric primary idiopathic partial epilepsy patients

Öz

Aim: Approximately 70% of temporal seizures are hippocampal seizures, which are often concomitant with amygdala seizures. Seizures occurring in this region are usually complex partial. The aim of this study was to determine whether there was a significant change in hippocampus and amygdala volumes in idiopathic partial epilepsy patients without pathology on routine cranial MRI and to compare the hippocampus and amygdala ADC values with the control group.

Methods: In this case-control study, 27 patients aged between 1-18 years, who were admitted to our hospital between the years of 2014 and 2017 and diagnosed with idiopathic partial epilepsy based on EEG and clinical findings were compared with 20 children in the control group, which consisted of twenty children of similar ages who were referred to our hospital with nonspecific complaints such as headache and dizziness and who underwent cranial MRI. Children with histories of any congenital diseases, acquired neurodegenerative diseases, intracranial infections, intracranial masses, and those who were perinatally affected were not included in the study. Drawings, volumetric measurements, and ADC calculations were performed by two separate evaluators (one neuroradiology and one radiology research assistant).

Results: Hippocampus and amygdala volumes of the study group were decreased compared to the control group, but the results were significant only for the left hippocampus. Although ADC values of the study group were increased, the findings were statistically significant only for the left amygdala.

Conclusion: In our study, we found that the hippocampus and amygdala volumes of patients diagnosed with idiopathic partial epilepsy were decreased ipsilateral to the seizure focus, and the ADC values of the ipsilateral amygdala were increased.

Anahtar Kelimeler

• Idiopathic partial epilepsy,Hippocampus,Amygdala,Pediatric,ADC

Pediatrik yaş grubu primer idiyopatik parsiyel epilepsi hastalarında bilateral hipokampus ve amigdala volümlerinin ADC değerleri ile karşılaştırmalı değerlendirilmesi

Öz

Amaç: Temporal nöbetlerin yaklaşık %70'i hipokampal nöbetlerdir ve genellikle amigdala nöbetleri ile birliktedir. Bu bölgede meydana gelen nöbetler genellikle kompleks parsiyel nöbetlerdir.Çalışmamızın amacı, rutin kraniyal MRG'de patolojisi olmayan 0-18 yaş arasındaki idiyopatik parsiyel epilepsi hastalarında hipokampus ve amigdala hacminde anlamlı bir değişiklik olup olmadığını belirlemek ve hastaların hipokampüs ile amigdala ADC değerlerini kontrol grubu ile karşılaştımalı olarak değerlendirmektir.

Yöntemler: Yapılan olgu-kontrol çalışmasında 2014 ve 2017 yılları arasında hastanemize başvuran, 1-18 yaş arasında olup, EEG ve klinik bulgularıyla idiyopatik parsiyel epilepsi tanısı alan 27 hasta ile 20 kontrol grubu karşılaştırıldı. Kontrol grubu olarak, benzer yaşlarda olup hastanemize baş ağrısı ve baş dönmesi gibi nonspesifik şikâyetlerle başvuran ve kraniyal MRG çekilen 20 çocuk değerlendirildi. Çalışma ve kontrol grubunda bilinen konjenital hastalık öyküsü olan, edinsel nörodejeneratif hastalık geçiren, intrakraniyal enfeksiyon ya da perinatal etkilenme öyküsü bulunan ve intrakraniyal kitlesi olan çocuklar çalışmaya dâhil edilmemiştir Çizimler, volümetrik ölçümler ve ADC ölçümleri iki ayrı değerlendirici tarafından yapıldılar (Biri nöroradyolog, diğeri radyoloji araştırma görevlisi).

Bulgular: Kontrol grubu ile karşılaştırıldığında, çalışma grubunda hipokampüs ve amigdala volümlerinde azalma izlenmekle beraber sonuçlar sadece sol hipokampüs için anlamlıydı. ADC değerlerinin karşılaştırılımasında çalışma grubunun ADC değerleri kontrol grubuna kıyasla artmış olmakla birlikte bulgular sadece sol amigdala için istatistiksel olarak anlamlıydı.

Sonuç: Çalışmamızda, idiyopatik parsiyel epilepsi tanısı alanlarda, hipokampus ve amigdala volümlerinin, nöbet odağına bağlı olarak ipsilateral azalmış olduğunu bulduk. Aynı zamanda, ipsilateral amigdalada ADC değerlerinde artış olduğunu bulduk.

Anahtar Kelimeler

• İdiyopatik Parsiyel Epilepsi,Hipokampüs,Amigdala,Pediyatrik,ADC

Kaynakça

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