Document Detail


Hippocampal sclerosis: MR prediction of seizure intractability.
MedLine Citation:
PMID:  17295625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Patients with refractory temporal lobe epilepsy (refractory TLE) often have hippocampal sclerosis (HS). However, some HS patients have less-severe, drug-responsive epilepsy (mild TLE). We investigated the pattern of MR changes in these two HS groups. METHODS: We acquired a 3D volumetric sequence, T(2) relaxation times (T2) and proton MR spectroscopy (MRS) in 41 HS patients (24 refractory TLE, 17 mild TLE) and 60 controls. Hippocampal volumes were measured bilaterally. T2 was measured in the hippocampus, amygdala, thalamus, in the white matter of the anterior temporal lobe (ATL), and in the frontal lobe. The temporal lobe MRS established concentrations of N-acetylaspartate (NAA), choline, creatine, myoinositol and glutamine/glutamate. RESULTS: The degree of hippocampal volume loss and hippocampal T2 increase was not different between the two HS groups. However, in refractory TLE, the T2 signal in the ipsilateral ATL was increased, and the ipsilateral NAA concentration was reduced (p < or = 0.05). CONCLUSIONS: In this group of HS patients, the degree of HS was not related to the clinical course, possibly reflecting the common cause of epilepsy. In contrast, refractory TLE patients had pronounced white matter changes and metabolite disturbance in the ipsilateral temporal lobe. These abnormalities may indicate the refractory nature of the epilepsy.
Authors:
Regula S Briellmann; R Mark Wellard; Richard A J Masterton; David F Abbott; Samuel F Berkovic; Graeme D Jackson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsia     Volume:  48     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-23     Citation Subset:  IM    
Affiliation:
Brain Research Institute, Austin Health, Heidelberg West, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aspartic Acid / analogs & derivatives,  metabolism
Choline / metabolism
Creatine / metabolism
Epilepsy, Temporal Lobe / diagnosis*,  metabolism
Female
Functional Laterality
Glutamic Acid / metabolism
Glutamine / metabolism
Hippocampus / metabolism*,  pathology*
Humans
Magnetic Resonance Spectroscopy / statistics & numerical data*
Male
Prognosis
Sclerosis / pathology
Severity of Illness Index
Temporal Lobe / metabolism,  pathology
Chemical
Reg. No./Substance:
56-84-8/Aspartic Acid; 56-85-9/Glutamine; 56-86-0/Glutamic Acid; 57-00-1/Creatine; 62-49-7/Choline; 997-55-7/N-acetylaspartate

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