The significance of bilateral CSI changes for the postoperative outcome in temporal lobe epilepsy.
OBJECTIVE
In a prospective study, we evaluated the significance of preoperative bilateral chemical shift spectroscopy imaging (CSI) changes for the prognosis of postoperative seizure outcome in the surgical treatment of patients with temporal lobe epilepsy (TLE).


METHODS
CSI using multivoxel spectroscopy was performed. Twenty-six consecutive TLE patients scheduled for epilepsy surgery were included. To evaluate the value of the CSI with respect to postoperative seizure outcome, discriminant analysis with ipsilateral and contralateral CSI was performed.


RESULTS
The discriminant analysis showed that the contralateral metabolic changes alone are able to predict seizure outcome whereby 92.3% of cases were correctly classified. Upon comparison of the two groups of seizure-free and non-seizure-free patients with respect to contralateral metabolic changes, the difference proved to be highly significant (paired t test: t = -6.3, df = 24, p < 0.001).


CONCLUSIONS
Bilateral metabolic CSI changes have a predictive value for the postoperative outcome in patients with TLE. In patients with severe bilateral metabolic changes, poor seizure outcome is a likely result.
Eberhardt
K E
KE
Department of Neurosurgery, University of Erlangen-Nuremberg, Germany. neoruradiologie@rzmail.uni-erlangen.de
Stefan
H
H
Buchfelder
M
M
Pauli
E
E
Hopp
P
P
Huk
W
W
Tomandl
B F
BF
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D016002:Discriminant Analysis; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005583:Fourier Analysis; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013702:Temporal Lobe / Q000378:metabolism; D016896:Treatment Outcome
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline