Prognostic value of qualitative magnetic resonance imaging hippocampal abnormalities in patients undergoing temporal lobectomy for medically refractory seizures.
In patients with temporal lobe epilepsy (TLE), high-resolution, magnetic resonance imaging (MRI) frequently demonstrates hippocampal atrophy and increased hippocampal signal. To assess the prognostic value of these findings, we studied 51 patients evaluated prospectively by a radiologist blinded to other preoperative evaluations. Thirty-one of 51 (61%) patients undergoing temporal lobectomy had visually apparent hippocampal atrophy or increased hippocampal signal on MRI (25 ipsilateral 3 contralateral, and 3 bilateral to the operated site). Patients with ipsilateral abnormalities became seizure-free more frequently than patients with normal scans [24 of 25 (96%) vs. 10 of 20 (50%) p < 0.015]. Both ipsilateral hippocampal atrophy and ipsilateral increased hippocampal signal independently predicted a seizure-free outcome. Qualitative MRI provides important prognostic information in patients undergoing temporal lobectomy.
Garcia
P A
PA
Department of Neurology, University of California, San Francisco 94143.
Laxer
K D
KD
Barbaro
N M
NM
Dillon
W P
WP
D001284:Atrophy / Q000473:pathology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011379:Prognosis; D012598:Sclerosis / Q000473:pathology; D012815:Signal Processing, Computer-Assisted; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome