Extent of Preoperative Abnormalities and Focus Lateralization Predict Postoperative Normalization of Contralateral 1H-Magnetic Resonance Spectroscopy Metabolite Levels in Patients with Temporal Lobe Epilepsy
G. Lantza,
M. Seeckb and
F. Lazeyrasc
a Functional Brain Mapping Laboratory, University Hospital, Geneva, Switzerland; and "Functional Neurology and Neurosurgery Program" of the Universities of Lausanne and Geneva, Switzerland
b Unit of Presurgical Epilepsy Evaluation, Neurology Clinic, University Hospital, Geneva, Switzerland; and "Functional Neurology and Neurosurgery Program" of the Universities of Lausanne and Geneva, Switzerland
c Department of Radiology, University Hospital, Geneva, Switzerland; and "Functional Neurology and Neurosurgery Program" of the Universities of Lausanne and Geneva, Switzerland
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Fig 1. NAA/(Cho+Cr) ratios in the contralateral neocortical temporal region and their relation to different patient parameters. Light gray bars, Preoperative values; dark gray bars, postoperative values. A, Patient number; B, preoperative MR spectroscopy abnormalities; N = normal, ihpc = ipsilateral hippocampus, itmp = ipsilateral temporal lobe, chpc = contralateral hippocampus, and ctmp = contralateral temporal lobe. C, Lobe with epileptic focus (L = left, R = right). D, Means and SDs of MR spectroscopy values in patients with decreasing (Pt 1–8) and increasing (Pt 9–15) postoperative MR spectroscopy values and in healthy subjects. In the patients in whom the MR spectroscopy values normalize (Pt 9–15), it does so from an abnormally low value (P = .03), whereas in the cases where the values decrease (Pt 1–8), they still always stay within the normal range as determined from the results in the healthy subjects.
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