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Proton Magnetic Resonance Spectroscopic Imaging Studies in Patients with Newly Diagnosed Partial Epilepsy
Author(s) -
Li Li Min,
Dubeau François,
Andermann Frederick,
Arnold Douglas L.
Publication year - 2000
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.1528-1157.2000.tb00249.x
Subject(s) - epilepsy , magnetic resonance imaging , magnetic resonance spectroscopic imaging , medicine , proton magnetic resonance , partial epilepsy , progressive myoclonus epilepsy , nuclear medicine , radiology , nuclear magnetic resonance , psychiatry , physics
Summary:Purpose : To assess whether the N ‐acetyl aspartate (NAA) to creatine ratio (NAA/Cr) is abnormally low at the onset of epilepsy and whether successful treatment of seizures with antiepileptic drugs is sufficient for normalization of NAA/Cr. Patients and Methods : Proton magnetic resonance spectro‐scopic imaging ( 1 H‐MRSI) was used to measure NAA/Cr in temporal lobes of eight patients with newly diagnosed epilepsy before or soon after starting medication. Six patients had follow‐up 1 H‐MRSI examinations 7 months later. Clinical pattern of the seizures and the EEG findings suggested partial seizures in all and TLE in five patients. None of the patients had lesional epilepsy according to magnetic resonance imaging. Results : Initial 1 H‐MRSI of the temporal lobes showed significantly low NAA/Cr values in five of eight patients. Five of six patients who had follow‐up 1 H‐MRSI were seizure‐free after using medication; the remaining patient did not take medication and continued to experience occasional auras. Wilcoxon rank sign comparison of NAA/Cr on initial 1 H‐MRSI examination and follow‐up 1 H‐MRSIs showed no significant difference ( Z = 135, p = 0.893, 2‐tailed) for five seizure‐free patients. Conclusions : Neuronal dysfunction is present at an early stage of the epileptic process. NAA/Cr recovery in seizure‐free patients controlled with antiepileptic drugs is less evident, compared with successful surgical treatment. Thus, absence of seizures is not necessarily coupled with NAA/Cr improvement and observed variable response warrants further investigation.