1H-MRS metabolite's ratios show temporal alternation in temporal lobe seizure: Comparison between interictal and postictal phases

- Investigation of metabolite changes after seizure was done.
- Significant decreases in NAA/Cr, NAA/Cho, NAA/Cho + Cr is detected immediately after ictus in ipsilateral hippocampus as compared with control data and controlateral hippocampus.
- No significant differences among all three groups in these metabolite ratios were detected in interictal phase.
- Ictal H-MRS can be considered as a possible adjunct tool in lateralizing and localizing of seizure foci in epileptic patients.

PurposesTo determine 1H-MRSI metabolites changes in interictal and postictal phases of patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis and lateralization of seizure foci.Materials and methodsMR spectroscopic imaging was performed in 5 adult patients with refractory temporal lobe epilepsy interictally and immediately after the seizure and in 4 adult control subjects. All patients underwent MR imaging and VideoEEG Monitoring.ResultsThe results showed statistically significant decreases in N-acetylaspartate/Creatine, N-acetylaspartate/Choline and N-acetylaspartate/(creatine + choline) immediately after ictus in ipsilateral hippocampus as compared with control data and contralateral hippocampus of patients while no statistically significant difference was presented in interictal phase.ConclusionThe present study clearly indicates 1H-MRS abnormalities following an ictus of temporal lobe epilepsy with metabolite recovery in interictal phase. This finding suggests postictal 1H-MRS as a possible useful tool to assist in lateralizing and localizing of seizure foci in epileptic patients with structural lesions.