Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography

AUTHORS

Hasan Aydin 1 , Nilay Aydin Oktay 1 , Volkan Kizilgoz 1 , * , Elif Altin Altin 1 , Idil Gunes Tatar 1 , Baki Hekimoglu 2

1 MRI Department, S.B. Ankara Diskapi Yildirim Beyazit Education and Research Hospital, [email protected], Turkey

2 Vascular Interventional Department, S.B. Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Turkey

How to Cite: Aydin H, Oktay N A, Kizilgoz V, Altin E, Tatar I, et al. Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography, Iran J Radiol. Online ahead of Print ; 9(1):1-11. doi: 10.5812/iranjradiol.6686.

ARTICLE INFORMATION

Iranian Journal of Radiology: 9 (1); 1-11
Published Online: March 25, 2012
Article Type: Research Article
Received: April 3, 2010
Accepted: December 19, 2011
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Abstract

Background: Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be correctly diagnosed and properly treated. Up to now, several diagnostic approaches have been processed to determine the epileptic focus.

Objectives: The aim of this study was to discover whether proton-MR-spectroscopic imaging (MRSI) aids in the diagnosis of temporal lobe epilepsy in conjunction with classical electroencephalography (EEG) findings.

Patients and Methods: Totally, 70 mesial temporal zones consisting of 39 right hippocampi and 31 left hippocampi of 46 patients (25 male, 21 female) were analyzed by proton MRSI. All patients underwent a clinical neurologic examination, scalp EEG recording and prolonged video EEG monitoring. Partial seizures on the right, left or both sides were recorded in all patients. All patients were under medical treatment and none of the patients underwent amygdalohippocampectomy and similar surgical procedures.

Results: The normal average lactate (Lac), phosphocreatine, N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), myo-inositol, glutamate and glutamine (Glx) peaks and Nacetyl aspartate/Cr, NAA/ Cho + Cr, Cho/Cr ratios were measured from the healthy opposite hippocampi or from the control subjects. The Lac, glutamate and glutamine (Glx), myo-inositol, phosphocreatine and NAA metabolites plus Cho/Cr ratio showed statistical difference between the normal and the epileptic hippocampi. Cho, Cr metabolites plus NAA/Cr, NAA/ Cho + Cr ratios were almost the same between the groups. The sensitivity of Proton-MR-Spectroscopy for lateralization of the epileptic foci in all patients was 96% and the specificity was 50%.

Conclusions: Proton-MRSI can easily be considered as an alternative modality of choice in the diagnosis of temporal lobe epilepsy and in the future; Proton-MR-Spectroscopy may become the most important technique used in epilepsy centers.

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© 2012, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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