Predictive value of 1H MRSI for outcome in temporal lobectomy.
OBJECTIVE
To investigate the predictive value of 1H MRSI for outcome in patients with mesial temporal lobe epilepsy (MTLE).


BACKGROUND
1H MRSI has been shown to be highly sensitive in the lateralization of temporal lob epilepsy.


METHODS
The authors analyzed the relationship between the 1H MRSI findings and surgical outcome in 40 consecutive patients who underwent temporal lobe surgery for MTLE. Outcome at a mean of 24 months (range 18 to 40 months) was classified as seizure free or not seizure free.


RESULTS
At follow-up, 78% of patients were seizure free. Correlations showed no predictive value for the creatine/N-acetylated compound (Cr/NA) ratio of the operated temporal lobe and outcome. However, a relationship was found between surgical failure and the Cr/NA ratio of the nonoperated temporal lobe and with a Cr/NA ratio in the nonoperated lobe above 1.21 in patients with bilateral abnormalities (p < 0.01).


CONCLUSIONS
Preoperative elevations in the Cr/NA ratio in the nonoperated temporal lobe or the presence of higher metabolic ratios contralateral to the proposed surgery are associated with surgical failure. The predictive value of 1H MRSI absolute metabolite concentrations for outcome in MTLE requires further investigation.
Kuzniecky
R
R
Department of Neurology, UAB Epilepsy Center, University of Alabama at Birmingham, USA.
Hugg
J
J
Hetherington
H
H
Martin
R
R
Faught
E
E
Morawetz
R
R
Gilliam
F
F
D000293:Adolescent; D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000378:metabolism* / Q000601:surgery*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011522:Protons; D013702:Temporal Lobe / Q000378:metabolism* / Q000601:surgery*
D011522:Protons