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Clinical Applications of Magnetic Resonance Spectroscopy
Author(s) -
Laxer Kenneth D.
Publication year - 1997
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1997.tb04534.x
Subject(s) - epilepsy , phosphomonoesters , temporal lobe , magnetic resonance imaging , neuroscience , medicine , central nervous system disease , focus (optics) , psychology , energy metabolism , radiology , phosphocreatine , physics , optics
Summary: Magnetic resonance spectroscopy (MRS) is a new tool for evaluation of patients with epilepsy, demonstrating abnormalities of energy and lipid metabolism ictally and, more recently, interictally. These metabolic abnormalities include increased inorganic phosphate, pH, and decreased phosphomono‐esters as determined by 31 P MRS, as well as decreased N‐ acetylaspartate determined by 1 H MRS. Furthermore, increased lactic acid has been detected postictally. These metabolic changes appear to be confined to the region of seizure origination and can be detected interictally. Therefore, they can be used for lateralization of the epileptogenic focus. Ongoing research suggests that these abnormalities may also be useful in localization of the focus, demonstrating metabolic alterations in temporal lobe epilepsy (TLE) similar to those in neocortical epilepsy. However, further technical development will be required before the goal of using these techniques for localization of the epileptogenic focus can be realized. For TLE lobe epilepsy at least, the clinical utility of 'H MRS to lateralize the seizure focus has clearly been demonstrated by several centers. The consistent findings in TLE suggest that 'H MRS is ready to become part of the evaluation process of patients with medically refractory epilepsy being evaluated for seizure surgery.