A Six-Year Follow-Up MRI Study of Complicated Early Childhood Convulsion

We have previously reported a greater than 50% prevalence of structural brain abnormalities in children within 2 weeks of first complicated early childhood convulsion, including significant hippocampal asymmetry unrelated to edema. In a 6-year follow-up study, 8 of the original 17 subjects were reimaged to determine any developments in hippocampal pathology. Three subjects manifested significantly greater asymmetry, and two exhibited a modest increase in asymmetry at follow-up compared with that present at initial magnetic resonance imaging. Two of the remaining three subjects manifested no change in the degree of hippocampal asymmetry that was already evident at initial scan, whereas in the final case, apparent resolution of previously identified (slight) hippocampal asymmetry had occurred. Elevated hippocampal T2 relaxation times did not consistently accord with smaller hippocampal volumes. These results suggest that complicated early childhood convulsion may be less benign than often supposed.