Abstract Details

Title Prevalence and clinico-radiological characteristics of Hippocampal Mal-Rotation (HIMAL) in an Epilepsy Clinic Population; A Retrospective Chart Review

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S36 - Epilepsy/Clinical Neurophysiology (EEG) II (1:33 PM-1:44 PM)

Poster/Presentation
Number 004

Background Mesial temporal sclerosis (MTS) and other types of hippocampal pathologies have been associated with epilepsy including HIMAL, which seems to be a common condition, found in patients with history of febrile convulsions and others with no known diagnosis of epilepsy. We intend to study the prevalence of HIMAL in patients seen in an epilepsy clinic, in addition to describing other pathologies that might be associated with it

Objective This study evaluates the prevalence of HIMAL and associated clinical and radiological features, in patients with and without and diagnosis of epilepsy, evaluated in an epilepsy clinic

Design/Methods Retrospective chart review of epilepsy clinic patients seen at a level 4 epilepsy center, out patient clinic by a single provider between 9/1/2011 and 8/31/2013. All MRIs were reviewed by one fellowship trained neuro-radiologist. HIMAL was defined based on radiologic criteria by Barsi et al. Total number of patients was 349 (target population)

Results Total number of patients seen is 349. Seizure protocol brain MRI with coronal T2 weighted images was performed in 294. 28 (9.5%) had HIMAL. 18 (2 with confirmed generalized epilepsy) out of 28 patients (64%) had a diagnosis of epilepsy. HIMAL was found in 10 (36%) out of 28 patients with no diagnosis of epilepsy. The most common associated MRI pathology was non-specific white matter disease or atrophy (6 patients). No pathologies found in 5 patients. 1 had bilateral MTS. 1 had a temporal lobectomy on the non-HIMAL side with pathologic evidence of ectopic neurons and gliosis. No patients with history of febrile convulsions

Conclusions HIMAL has been associated with epilepsy and febrile seizures. Causal inference in our opinion cannot be confirmed. Prevalence may be higher in the epilepsy vs non-epilepsy population. Further prospective studies with controls may be helpful for further affirmative conclusions

Authors/Disclosures
Najib I. Murr, MD, FAAN (Northoaks hospital) PRESENTER	Dr. Murr has nothing to disclose.
Rebecca J. Thompson, MD (Dartmouth-Hitchcock Medical Center Dept of Neurology)	No disclosure on file
Abdullah Al Sawaf, MD (SIU Medicine)	Dr. Al Sawaf has nothing to disclose.
Sanaz Karimi, MD	No disclosure on file
	No disclosure on file

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