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Magnetic resonance imaging-based volume studies in temporal lobe epilepsy: pathological correlations
G D Cascino1, C R Jack, J E Parisi
1Department of Neurology, Mayo Clinic, Rochester, MN.
Annals of Neurology
|July 11, 1991
Summary
Magnetic resonance imaging (MRI) volume measurements of the hippocampal formation can accurately lateralize the seizure origin in most epilepsy patients. This technique enhances diagnostic yield for mesial temporal sclerosis.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Intractable partial epilepsy often originates from the temporal lobe.
- Accurate localization of seizure origin is crucial for surgical planning.
- Mesial temporal sclerosis is a common cause of refractory epilepsy.
Purpose of the Study:
- To evaluate the correlation between magnetic resonance imaging (MRI) hippocampal formation volume measurements and histopathology in patients with epilepsy.
- To determine the diagnostic yield of quantitative MRI in lateralizing seizure origin.
Main Methods:
- Prospective study of 24 patients with intractable partial epilepsy undergoing anterior temporal lobectomy.
- Correlation of MRI-derived hippocampal formation volume with post-operative histopathological findings.
- Exclusion of patients with mass lesions.
Main Results:
- Quantitative hippocampal formation atrophy correctly lateralized seizure origin in 71% of patients.
- MRI volume studies were indeterminate in 29% of cases.
- Severity of hippocampal pathology correlated with MRI-determined volume.
- Mesial temporal sclerosis was present in 15 patients, with MRI indicating atrophy in 14 (93%).
Conclusions:
- MRI-based hippocampal formation volume measurements increase the diagnostic yield of MRI in patients with intractable partial epilepsy.
- This quantitative MRI approach is valuable for diagnosing mesial temporal sclerosis and lateralizing seizure origin.