Magnetic resonance spectroscopy in epilepsy
Briellmann, Regula S., Wellard, R. Mark, & Jackson, Graeme D. (2005) Magnetic resonance spectroscopy in epilepsy. In Gillard, Jonathan H., Waldman, Adam D., & Barker, Peter B. (Eds.) Clinical MR neuroimaging diffusion, perfusion and spectroscopy. Cambridge University Press, Cambridge, pp. 488-508.
Key points • The clinical aims of MR spectroscopy (MRS) in seizure disorders are to help identify, localize and characterize epileptogeic foci. • Lateralizing MRS abnormalities in temporal lobe epilepsy (TLE) may be used clinically in combi- nation with structural and T2measurements. • Characteristic metabolite abnormalities are decreased N-acetylaspartate (NAA) with increased choline (Cho) and myoinositol (mI) (short-echo time). • Contralateral metabolite abnormalities are frequently seen in TLE, but are of uncertain significance. • In extra-temporal epilepsy, metabolite abnor- malities may be seen where MR imaging (MRI) is normal; but may not be sufficiently local- ized to be useful clinically. • MRS may help to characterize epileptogenic lesions visible on MRI (aggressive vs. indolent neoplastic, dysplasia). • Spectral editing techniques are required to evaluate specific epilepsy-relevant metabolites (e.g. -aminobutyric acid (GABA)) which may be useful in drug development and evaluation. • MRS with phosphorus (31P) and other nucleii probe metabolism of epilepsy, but are less useful clinically.
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