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Neurology. 1998 Jul;51(1):61-6.

Proton magnetic resonance spectroscopy in MRI-negative temporal lobe epilepsy.

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  • 1Radiology and Physics Unit, Institute of Child Health, University College London Medical School, and Great Ormond Street Hospital for Children, UK.

Abstract

OBJECTIVE:

To determine the 1H MRS findings in patients with intractable temporal lobe epilepsy (TLE) who had no detectable abnormality on either qualitative or quantitative MRI.

BACKGROUND:

Previous work has indicated that approximately 20% of patients with TLE remain MRI negative after extensive qualitative and quantitative investigation. Single-voxel 1H MRS provides a means of identifying potentially diffuse disease.

METHODS:

Seven patients with intractable TLE, normal routine MRI, normal hippocampal volumes, and normal hippocampal and amygdala quantitative T2 values underwent single-voxel 1H MRS of the medial temporal lobes. The results are compared with those from 13 control subjects and 15 patients with evidence of hippocampal sclerosis (HS).

RESULTS:

The ratio N-acetylaspartate/(choline-creatine + phosphocreatine) was abnormally low in five of the seven MRI-negative patients. In two of these patients, the ratios were low bilaterally. The observed MRS ratios in the MRI-negative group with abnormal EEG were similar to those from temporal lobes ipsilateral to HS, suggesting the presence of widespread or diffuse disease of a similar degree in both groups.

CONCLUSIONS:

These results demonstrate that MRS can provide evidence of temporal lobe abnormalities in TLE patients who show no abnormality on extensive MRI investigation.

PMID:
9674779
[PubMed - indexed for MEDLINE]
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