The aid of magnetic resonance spectroscopy in the evaluation of temporal lobe epilepsy

SUMMARYPurposeTemporal lobe epilepsy (TLE) is the most prevalent cause of complex partial seizures.Surgical treatment is an effective therapeutic option for patients who have drug refractoryepilepsy. In this study, we sought to examine hippocampus pathologies by using MRS in TLEpatients.Materials and MethodsThirty-six patients with clinically known TLE, sixteen patients with extra-temporalepilepsy, and the control group of twelve patients with history of headache were enrolled inthis study. After examining clinical history and lateralization of the focus side with EEG allpatients underwent MRI (magnetic resonance imaging) and MRS. For examination ofhippocampus oblique coronal FLAIR and FSE-IR images with thin slices were performed inaddition to the routine cranial MRI protocol. The mesial temporal lobes were investigatedwith MVS with TE of 135 and 35 ms.ResultsThe most consistent MRI features for the evaluation of the hippocampus were atrophy(27.7%), signal alterations (11%), and temporal horn asymmetry (19.4%). With TE 135 msNAA/Cho, and NAA/Cre ratios; and TE 35 ms NAA levels, and NAA/Cho+Cre, NAA/Crratios were significantly different between patient and control groups and were lower in TLEpatients.ConclusionMRS is important for the lateralization of the focus side. When MRS is compared withMRI, MRS can reveal the pathological changes in an early stage.