title: [Proton MR spectroscopy in patients with unilateral temporal lobe epilepsy].
abstract: The authors assessed proton magnetic resonance spectroscopy (1H-MRS) in patients with unilateral refractory temporal bole epilepsy. The subjects consisted of 20 patients (those with brain tumors, trauma, malformations or definite organic lesions were excluded) and 10 normal volunteers. 1H-MRS and MRI were performed using a 1.5 tesla machine. 1H-MRS was achieved using point-resolved spectroscopy (PRESS) or the stimulated echo acquisition mode (STEAM), and a 3 x 3 x 3 cm volume of interest was positioned at the hippocampus. N-Acetyl-aspartate (NAA) and choline-containing substance (Cho) signals were evaluated. The results showed decreased NAA and elevated Cho or asymmetry of both NAA and Cho in the epileptogenic focus in 19/20 cases. The reductions in NAA presumably reflect neuronal loss, while the elevation of Cho probably represents membrane break down within the lesion. These abnormalities were observed in 19/20 cases (95%), whereas abnormal magnetic resonance imaging was detected in only 6/20 (30%) of the patients. Thus, 1H-MRS appears to be a useful, non-invasive modality for evaluating metabolic changes in epileptogenic foci, and these metabolic changes can serve as a more sensitive indicator than magnetic resonance imaging.
authors.affiliation: Kashiwaba Neurosurgical Hospital, Sapporo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: K
authors.initials: K
authors.lastname: Kamada
authors.forename: K
authors.initials: K
authors.lastname: Itamoto
authors.forename: H
authors.initials: H
authors.lastname: Ohtuki
authors.forename: K
authors.initials: K
authors.lastname: Isonishi
authors.forename: N
authors.initials: N
authors.lastname: Nakayama
authors.forename: M
authors.initials: M
authors.lastname: Shimoyama
authors.forename: K
authors.initials: K
authors.lastname: Tokuda
authors.forename: M
authors.initials: M
authors.lastname: Koiwa
authors.forename: T
authors.initials: T
authors.lastname: Kashiwaba
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000378:metabolism / Q000473:pathology; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged