title: Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study.
abstract: The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus.
  
  
  
  Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn.
  
  
  
  Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P < .001; adjusted OR, 10.59). Multiple morphologic parameters correlated with febrile status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities.
  
  
  
  Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum.
authors.affiliation: From Departments of Radiology (A.C.M., W.A.G., J.A.B.).
authors.forename: A C
authors.identifier: 0000-0001-5241-799X
authors.initials: AC
authors.lastname: McClelland
authors.affiliation: From Departments of Radiology (A.C.M., W.A.G., J.A.B.) wgomes@montefiore.org.
authors.forename: W A
authors.identifier: 0000-0002-5046-1505
authors.initials: WA
authors.lastname: Gomes
authors.affiliation: Neurology (S. Shinnar, S.L.M., R.C.S.).|Pediatrics (S. Shinnar, S.L.M.).|Epidemiology and Population Health (S. Shinnar).
authors.forename: S
authors.identifier: 0000-0001-6714-3960
authors.initials: S
authors.lastname: Shinnar
authors.affiliation: Departments of Epidemiology (D.C.H., M.C.).
authors.forename: D C
authors.identifier: 0000-0003-1783-5381
authors.initials: DC
authors.lastname: Hesdorffer
authors.affiliation: Department of Health Evidence and Policy (E.B.), Mount Sinai School of Medicine, New York, New York.
authors.forename: E
authors.identifier: 0000-0002-3582-6502
authors.initials: E
authors.lastname: Bagiella
authors.affiliation: Departments of Pediatrics (Neurology) (D.V.L.).
authors.forename: D V
authors.identifier: 0000-0003-2917-7822
authors.initials: DV
authors.lastname: Lewis
authors.affiliation: From Departments of Radiology (A.C.M., W.A.G., J.A.B.).
authors.forename: J A
authors.identifier: 0000-0002-6540-4423
authors.initials: JA
authors.lastname: Bello
authors.affiliation: Radiology (S.C.), Gertrude H. Sergievsky Center, Columbia University, New York, New York.
authors.forename: S
authors.identifier: 0000-0002-1410-7998
authors.initials: S
authors.lastname: Chan
authors.affiliation: Radiology (J.M.), Duke University Medical Center, Durham, North Carolina.
authors.forename: J
authors.identifier: 0000-0001-9012-133X
authors.initials: J
authors.lastname: MacFall
authors.affiliation: Departments of Epidemiology (D.C.H., M.C.).
authors.forename: M
authors.identifier: 0000-0002-7226-2638
authors.initials: M
authors.lastname: Chen
authors.affiliation: Departments of Neurology (J.M.P.).
authors.forename: J M
authors.identifier: 0000-0002-2121-5516
authors.initials: JM
authors.lastname: Pellock
authors.affiliation: Department of Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
authors.forename: D R
authors.identifier: 0000-0002-1617-0667
authors.initials: DR
authors.lastname: Nordli
authors.affiliation: Department of Neurology (L.M.F.), Children's Hospital of The King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: L M
authors.identifier: 0000-0002-4250-1327
authors.initials: LM
authors.lastname: Frank
authors.affiliation: Neurology (S. Shinnar, S.L.M., R.C.S.).|Pediatrics (S. Shinnar, S.L.M.).|Neuroscience (S.L.M.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: S L
authors.identifier: 0000-0001-9427-9476
authors.initials: SL
authors.lastname: Moshé
authors.affiliation: Neurology (S. Shinnar, S.L.M., R.C.S.).
authors.forename: R C
authors.identifier: 0000-0002-2274-6837
authors.initials: RC
authors.lastname: Shinnar
authors.affiliation: Biostatistics (S. Sun), Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: S
authors.identifier: 0000-0002-9209-6294
authors.initials: S
authors.lastname: Sun
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006624:Hippocampus / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D059906:Neuroimaging; D003294:Seizures, Febrile / Q000209:etiology*; D013226:Status Epilepticus / Q000209:etiology*; D013702:Temporal Lobe / Q000002:abnormalities* / Q000000981:diagnostic imaging