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Stefan, H; Feichtinger, M; Pauli, E; Schäfer, I; Eberhardt, KW; Kasper, BS; Hopp, P; Buchfelder, M; Huk, J; Paulus, W.
Magnetic resonance spectroscopy and histopathological findings in temporal lobe epilepsy.
Epilepsia. 2001; 42(1):41-46 Doi: 10.1046%2Fj.1528-1157.2001.080873.x
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Feichtinger Michael
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Abstract:
PURPOSE: In some patients with temporal lobe epilepsy, histopathological evaluation of resected brain tissue after surgical treatment may reveal several features indicative of discrete cortical malformations. We sought to determine whether these histopathological features were accompanied by hippocampal changes detectable preoperatively by proton magnetic resonance (MR) spectroscopy and to evaluate their relationship with postoperative outcome. METHODS: In 25 consecutive temporal lobe epilepsy patients who were scheduled for surgical treatment, MR spectroscopy was performed, and resected brain tissue was analyzed histopathologically for the presence of discrete cortical malformations (e.g., microdysgenesis). Outcome was assessed in all patients with an average postoperative period of 26 months. RESULTS: In 13 patients, we found subtle, histopathologically detectable signs of cortical malformation: 6 of them with concomitant hippocampal sclerosis (dual pathology) and 7 without. The latter subgroup had a worse surgical outcome and showed enhanced bilateral and/or contralateral pathological changes in the hippocampal formation when investigated by MR spectroscopy. CONCLUSIONS: These data suggest that by showing contralaterally or bilaterally abnormal spectra, MR spectroscopy might be able to indicate pathological changes in subtle developmental disorders that are possibly more widespread over the brain. This observation may improve noninvasive diagnosis in presurgical evaluation and the neurobiological understanding of cortical malformations in pharmacoresistant temporal lobe epilepsy.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Epilepsy, Temporal Lobe - diagnosis
Female - diagnosis
Functional Laterality - diagnosis
Hippocampus - pathology
Humans - pathology
Magnetic Resonance Imaging - statistics and numerical data
Magnetic Resonance Spectroscopy - statistics and numerical data
Male - statistics and numerical data
Middle Aged - statistics and numerical data
Sclerosis - diagnosis
Temporal Lobe - abnormalities
Treatment Outcome - abnormalities

Find related publications in this database (Keywords)
MR spectroscopy
cortical malformations
pharmacoresistant temporal lobe epilepsy
neuropathology
surgical outcome
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