Hippocampal Sclerosis: MR Prediction of Seizure Intractability

Autor: Graeme D. Jackson, David F. Abbott, Samuel F. Berkovic, Richard A.J. Masterton, Regula S. Briellmann, R. Mark Wellard
Rok vydání: 2007
Předmět:
Male
Pathology
Magnetic Resonance Spectroscopy
Glutamine
Hippocampus
Hippocampal formation
Severity of Illness Index
Functional Laterality
Choline
Epilepsy
111601 Cell Physiology
110300 CLINICAL SCIENCES
110902 Cellular Nervous System
110900 NEUROSCIENCES
100499 Medical Biotechnology not elsewhere classified
100402 Medical Biotechnology Diagnostics (incl. Biosensors)
Prognosis
Temporal Lobe
110100 MEDICAL BIOCHEMISTRY AND METABOLOMICS
060000 BIOLOGICAL SCIENCES
medicine.anatomical_structure
Neurology
Frontal lobe
Anesthesia
060105 Cell Neurochemistry
Female
MRI
TLE
Adult
060104 Cell Metabolism
110000 MEDICAL AND HEALTH SCIENCES
MRS
medicine.medical_specialty
110903 Central Nervous System
Glutamic Acid
Severity
Temporal lobe
White matter
119900 OTHER MEDICAL AND HEALTH SCIENCES
Atrophy
Seizures
medicine
Humans
060100 BIOCHEMISTRY AND CELL BIOLOGY
110904 Neurology and Neuromuscular Diseases
Aspartic Acid
Hippocampal sclerosis
Sclerosis
business.industry
Creatine
medicine.disease
111600 MEDICAL PHYSIOLOGY
nervous system diseases
refractory
Epilepsy
Temporal Lobe
nervous system
Neurology (clinical)
business
Zdroj: Epilepsia
ISSN: 1528-1167
0013-9580
DOI: 10.1111/j.1528-1167.2006.00932.x
Popis: 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.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.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 (por = 0.05).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.
Databáze: OpenAIRE
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