1H-MR spectroscopy: a promising method in distinguishing subgroups in temporal lobe epilepsy?

Hammen,; Stefan, H.; Pauli, E.; Schäfer, I.; Huk, W.; Tomandl, B.

doi:10.1016/S0022-510X(03)00174-6

« Previous Next »Journal of the Neurological Sciences
Volume 215, Issue 1 , Pages 21-25, 15 November 2003

1H-MR spectroscopy: a promising method in distinguishing subgroups in temporal lobe epilepsy?

Hammen
- Department of Neurology, Center Epilepsy, Neurologische Klinik Mit Poliklinik, University Erlangen-Nürnberg, ZEE: Zentrum Epilepsie Erlangen Schwabachanlage 6, Erlangen D-91054, Germany
H. Stefan
- Corresponding author. Tel.: +49-91318534541; fax: +49-91318536469.
- Department of Neurology, Center Epilepsy, Neurologische Klinik Mit Poliklinik, University Erlangen-Nürnberg, ZEE: Zentrum Epilepsie Erlangen Schwabachanlage 6, Erlangen D-91054, Germany
E. Pauli
- Department of Neurology, Center Epilepsy, Neurologische Klinik Mit Poliklinik, University Erlangen-Nürnberg, ZEE: Zentrum Epilepsie Erlangen Schwabachanlage 6, Erlangen D-91054, Germany
I. Schäfer
- Department of Neurology, Center Epilepsy, Neurologische Klinik Mit Poliklinik, University Erlangen-Nürnberg, ZEE: Zentrum Epilepsie Erlangen Schwabachanlage 6, Erlangen D-91054, Germany
W. Huk
- Department of Neuroradiology, University Erlangen-Nürnberg, Germany
B. Tomandl
- Department of Neuroradiology, University Erlangen-Nürnberg, Germany

Received 28 August 2002; received in revised form 25 March 2003; accepted 19 May 2003.

Abstract

Proton MR spectroscopy offers an additional noninvasive method of supporting focus lateralization in patients with intractable temporal lobe epilepsy. In this study involving 57 patients, the ability of multivoxel 1H-MRS to differentiate between mesial and lateral TLE was investigated in addition to its ability to lateralize the epileptogenic focus. Temporal lobe epilepsy (TLE) was classified into mesiobasal or lateral temporal lobe epilepsy according to the results of preoperative diagnostics including neurological and neuropsychological examinations, video-EEG monitoring and high resolution MRI. 1H-MR-spectroscopy (1H-MRS) showed that pathological changes in the mesial temporal lobes indicate a predominance in different parts of the ipsilateral temporal lobe (hippocampal and parahippocampal areas) correlating to the clinically defined groups. In addition, mesiobasal TLE tends to have higher concomitant contralateral abnormalities. Our results reveal that 1H-MRS is able to distinguish between mesiobasal and lateral pathologies in patients with TLE and represents a useful tool for noninvasive TLE classification.

Keywords: Temporal lobe epilepsy, 1H-MRS, Mesial, Lateral TLE