Effect of seizure on hippocampus in mesial temporal lobe epilepsy and neocortical epilepsy: an MRS study

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Lee, S K; Kim, D W; Kim, K K; Chung, C K; Song, I C; Chang, K H
Issue Date
Springer Verlag
Neuroradiology. 2005 Dec;47(12):916-23. Epub 2005 Sep 13.
AdultAspartic Acid/analogs & derivatives/analysisCase-Control StudiesCholine/analysisEpilepsy, Temporal Lobe/*complicationsFemaleHippocampus/*pathology/*physiology/radionuclide imagingHumansMagnetic Resonance SpectroscopyMaleNeocortex/pathologyProtonsSeizures/*complications
This study was performed to evaluate the effect of seizures on the bilateral hippocampus in mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy by single voxel proton magnetic resonance spectroscopy (MRS). Forty-one patients with mTLE having unilateral hippocampal sclerosis and 43 patients with a neocortical epilepsy who underwent subsequent epilepsy surgery were recruited. Ninety-five percent confidence intervals of N-acetyl aspartate/choline (NAA/Cho) and NAA/creatine (NAA/Cr) ratios in 20 healthy control subjects were used as threshold values to determine abnormal NAA/Cho and NAA/Cr. NAA/Cho and NAA/Cr were significantly lower in the ipsilateral hippocampus of mTLE and neocortical epilepsy. Using asymmetry indices for patients with bilaterally abnormal ratios of NAA/Cho and NAA/Cr in addition to using unilateral abnormal ratio, the seizure focus was correctly lateralized in 65.9% of patients with mTLE and 48.8% of neocortical epilepsy patients. Bilateral NAA/Cho abnormality was significantly related to a poor surgical outcome in mTLE. No significant relationship was found between the results of NAA/Cho or NAA/Cr and surgical outcome in neocortical epilepsy. The mean contralateral NAA/Cr ratio of the hippocampus in mTLE was significantly lower in patients with a history of secondary generalized tonic-clonic seizure (SGTCS) than in those without. Our results demonstrate effects of seizures on the hippocampi in neocortical epilepsy and the relation between SGTCS and NAA/Cr of the contralateral hippocampus in mTLE. This proves the presence of a seizure effect on the hippocampus in neocortical epilepsy as well as in mTLE.
0028-3940 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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