Hippocampal sclerosis: MR prediction of seizure intractability
Briellmann, Regula S., Wellard, R. Mark, Masterton, Richard A., Abbott, David F., Berkovic, Samuel F., & Jackson, Graeme D. (2007) Hippocampal sclerosis: MR prediction of seizure intractability. Epilepsia, 48(2), pp. 315-323.
Summary: Purpose: 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.
Methods: We acquired a 3D volumetric sequence, T2 relax-
ation 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 mea-
sured 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 glu-
Results: The degree of hippocampal volume loss and hip-
pocampal T2 increase was not different between the two HS
groups. However, in refractory TLE, the T2 signal in the ipsilat-
eral ATL was increased, and the ipsilateral NAA concentration
was reduced (p
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