Proton magnetic resonance spectroscopic observations of epilepsia partialis continua in children.
We performed magnetic resonance spectroscopy in three pediatric patients (two boys and one girl, ages 11 to 17 years) with epilepsia partialis continua. Single-voxel proton magnetic resonance spectroscopy was performed on each patient. Data were acquired from voxels of 4 or 8 cm3 from the affected hemisphere and from contralateral homologous regions. The spectral peaks of several metabolites (N-acetyl-aspartate, choline, creatine, and lactate) were measured. Neuropathologic findings revealed Rasmussen's syndrome in two children and gliosis in one. We observed increased lactate-to-creatine ratios and reduced N-acetyl-aspartate-to-creatine ratios in the affected hemispheres in all three children with epilepsia partialis continua. These data support previous reports. The largest increase in the lactate-to-creatine ratio was detected in a patient with Rasmussen's syndrome and ongoing epilepsia partialis continua at the time of measurement. The other two patients had an increase in the lactate-to-creatine ratio and a decrease in the N-acetyl-aspartate-to-creatine ratio in the affected area. The increased lactate-to-creatine ratio was associated with recurrent focal seizures from different underlying pathologies.
Park
Y D
YD
Department of Neurology, Medical College of Georgia, Augusta 30912, USA. ypark@neuro.mcg.edu
Allison
J D
JD
Weiss
K L
KL
Smith
J R
JR
Lee
M R
MR
King
D W
DW
D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D002648:Child; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D017036:Epilepsia Partialis Continua / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005911:Gliosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D016896:Treatment Outcome
D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline