Correlation of scalp EEG and 1H-MRS metabolic abnormalities in temporal lobe epilepsy.
OBJECTIVE
To correlate the interictal spike field and region of seizure onset with the distribution of 1H-MRS abnormalities in temporal lobe epilepsy (TLE) and improve our understanding of the clinical significance of 1H-MRS abnormalities.


METHODS
Scalp electroencephalogram (EEG) monitoring and proton magnetic resonance spectroscopy (1H-MRS) results were correlated in 31 consecutive patients with TLE.


RESULTS
Lateralized 1H-MRS-based hippocampal abnormalities were recorded in 95% of the patients with unilateral interictal spikes, with a high degree of concordance for the lateralization side (90%). In 64% of the patients with normal or bilateral interictal EEG spikes, 1H-MRS provided lateralizing information. Bilateral 1H-MRS abnormalities, with or without lateralization, were 3 times more frequent than bitemporal EEG spikes. Anterior predominance of the 1H-MRS abnormalities was more frequent in patients with anterior temporal EEG spiking (50%), than in patients without this EEG distribution (18%). Similar association was noted between distribution of 1H-MRS abnormalities and region of EEG seizure onset.


CONCLUSIONS
Our results show a moderate level of concordance between the distribution of 1H-MRS and EEG abnormalities. 1H-MRS identifies abnormalities contralateral to the predominant seizure focus more often than does EEG and may provide lateralizing information in patients with nonlateralizing interictal EEG.
Maton
B
B
Department of Neurology, Center for Nuclear Imaging Research, University of Alabama at Birmingham, USA.
Gilliam
F
F
Sawrie
S
S
Faught
E
E
Hugg
J
J
Kuzniecky
R
R
D000328:Adult; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006624:Hippocampus / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006859:Hydrogen; D009682:Magnetic Resonance Spectroscopy / Q000706:statistics & numerical data*; D008297:Male; D013702:Temporal Lobe / Q000378:metabolism*
D006859:Hydrogen