This is a follow-up study on patients with temporal lobe epilepsy (TLE) and healthy controls who were evaluated 4 years previous to this study. The study will advance the clinical and theoretical understanding of childhood epilepsy and provide new knowledge regarding the effects of neurological disease on brain growth, cognitive development and psychiatric morbidity. MRI will be used to measure brain volume (grey matter, white matter, and CSF). Brain volumetrics will be compared with test-retest cognitive decline in TLE patients. Also, diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI) will be used to evaluate the corpus collosum for volumetric reduction attributable to demyelination. Finally, MRI will be used to determine whether there are progressive effects of epilepsy on functional brain activation (fMRI) of the mesial temporal region during a memory task.
The specific aims are as follows: 1) Determine the nature and extent of abnormalities in cognitive function and brain structure and their relationship in children with new onset localization-related epilepsy, 2) Determine the rate and nature of neurodevelopmental abnormalities (maternal reproductive history, neonatal history, developmental milestones, initial precipitating injuries) and their relationship to anomalies in brain structure and cognitive function in children with new onset localization-relate epilepsy, 3) Characterize the impact of a two-year course on brain growth, cognitive development, and psychiatric morbidity, 4) Determine the relative impact of clinical seizure characteristics (seizure severity and frequency) versus age of epilepsy onset on longitudinal changes in brain growth, cognitive development, and psychiatric morbidity, and 5) Characterize the nature of the abnormality in cerebral white matter and the neurobehavioral consequences of reduced cerebral connectivity.