Lateralizing Ability of Magnetic Resonance Spectroscopy and Diffusion Tensor imaging in Temporal Lobe Epilepsy

Abstract

Background : Temporal lobe epilepsy (TLE) is the most common type of intractable and partial epilepsies. The only standard treatment for seizure-free status with manifest TLE is surgical, which includes amygdalohippocampectomy. The majority of temporal lobe seizures originates in the mesial temporal structures, primarily in the hippocampus, parahippocampal gyrus, and amygdala. Objectives : To compare the lateralizing ability of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in patients with TLE. Patients and methods : The study recruited 50 participants who were assigned into two groups: the fi rst group included 25 epileptic cases and the second group included 25 normal controls. Age showed a mean ± SD of 24.22 ± 9.7 years. All participants were subjected to the following, clinical assessment, electroencephalography, and radiological assessment including MRI epilepsy protocol, MRS, and DTI. Data were collected, revised, then extracted, and coded in Excel fi les. Results : MRS has demonstrated consistent metabolic abnormalities in partial seizures. Semiology showed the highest and the most perfect diagnostic ability indices for epilepsy (100%), followed by MRS (accuracy ¼ 92%), and DTI difference more than or equal to 0.014 (accuracy ¼ 86%). Conclusion : Semiology showed the highest and the most perfect diagnostic ability indices for epilepsy (100%). MRS is a highly sensitive tool to predict the TLE (accuracy ¼ 92%). DTI difference more than or equal to 0.014 (accuracy ¼ 86%), so it has high value also in the diagnosis of TLE.