Magnetic Resonance Imaging Evidence of Hippocampal Sclerosis in Asymptomatic, First-Degree Relatives of Patients With Familial Mesial Temporal Lobe Epilepsy

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Abstract
FAMILIAL MESIAL temporal lobe epilepsy (FMTLE) is a well-characterized syndrome that occurs in a large proportion of affected individuals with magnetic resonance imaging (MRI) evidence of hippocampal sclerosis (HS), including quantitative analyses.1-3 The identification of clear-cut hippocampal atrophy (HA) and additional MRI signs of HS in patients with a benign clinical course in these families supports the theory that a genetic factor determines hippocampal pathologic abnormalities in FMTLE.1,3 In addition, the finding of subtle hippocampal malformation in asymptomatic relatives of patients who present with complex febrile seizures4 suggests that inherited dysgenetic abnormalities may lead to a predisposition to seizures in these families. The MRI findings for family members asymptomatic for FMTLE have not been previously reported. The investigation of mesial temporal abnormalities in high-resolution MRI in first-degree relatives of familial patients can be helpful for investigating if these families segregate MRI evidence of HS in individuals without clinical manifestation of the disease. The objective of this study was to investigate whether asymptomatic relatives of patients with FMTLE have MRI evidence of HS.