Magnetic Resonance Spectroscopy in Temporal Lobe Epilepsy

• Main Authors: Siddharth Prakash, Vikram Narang, Ranjan Kukreti, Deepak Goel
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2017-10-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: Brain; Hippocampal sclerosis; Seizures
• Online Access: http://www.ijars.net/articles/PDF/2319/28354_CE(VSU)_F(AK)_PF1(VSU_GG)_PFA(GG)_PF2(VSU_GG).pdf

Introduction: Epilepsy affects 2% to 5% of the population at some time in their lives and hippocampal sclerosis accounts for 50% to 70% of cases. The role of proton magnetic resonance spectroscopy (1H-MRS) has been shown to be a useful tool in investigating in vivo and noninvasively key molecules of brain metabolism but the data from Indian subcontinent is scarce. Aim: To evaluate and compare the visual and volumetric findings on Magnetic Resonance Imaging (MRI) and to study the metabolite concentration variation in patients with Temporal Lobe Epilepsy (TLE) through MR Spectroscopy. Materials and Methods: The present case control study was done over a period of 18 months in Department of Radiodiagnosis, Himalayan Institute of Medical Sciences, Dehradun. The patients with temporal lobe epilepsy were studied with selection criteria defined under International League against Epilepsy 1989 convention. The matched non-epileptic controls of similar age and sex were taken up for the study. MR examination was performed on a 1.5 –T MR System with a circular polarizing head coil. Statistical analysis was done using Chi square test and p-value was calculated accordingly. Results: In patients by including both the normally lateralized and bilaterally lateralized groups, NAA was able to lateralize in 14 of 15 cases. NAA/Cr and NAA/Cho both performed less well than NAA and NAA/Cr+Cho with only 11 and 10 patients, respectively being lateralized correctly. NAA concentration and NAA/Cr+Cho ratio were reduced in hippocampi with HS (Hippocampal sclerosis) when compared with control and contralateral sides (at a = 0.01). Conclusion: MR imaging is the neuroimaging variety of choice for such patients. But even MR imagine cannot lateralize all cases. Better sensitivity has been reported with magnetic resonance spectroscopic but the findings have been found to vary widely.