Lateralization of human focal epilepsy by 31 p magnetic resonance spectroscopic imaging

J. W. Hugg, K. D. Laxer, G. B. Matson, A. A. Maudsley, C. A. Husted, M. W. Weiner

Research output: Contribution to journalArticlepeer-review

88 Scopus citations

Abstract

We attempted to lateralize the epileptogenic focus (seven temporal lobe hippocampal foci, one frontal lobe focus) in medically refractory unilateral complex partial seizures, using noninvasive 31P magnetic reso-nance spectroscopic imaging (MRSI) blindly and interictally to compare hippocampal or frontal regions. The seizure foci were more alkaline (intracellular pH = 7.17 ± 0.03) compared with the contralateral region (7.06 + 0.02, p < 0.01) in all eight cases; the inorganic phosphate was relatively increased (240 + 50% of contralateral, seven of eight cases, p < 0.01); and phosphomonoesters were relatively reduced (68 + 9% of contralateral, seven of eight cases, p < 0.01). Other phosphorus metabolites were symmetric (±10%). 31P MRSI correctly lateralized the seizure focus in all eight cases. By comparison, imaging correctly lateralized four cases and SPECT, two cases. In conclusion, 31P MRSI is a use-ful tool for the noninvasive clinical assessment of focal epilepsy and can accurately lateralize the epileptogenic focus.

Original languageEnglish (US)
Pages (from-to)2011-2018
Number of pages8
JournalNeurology
Volume42
Issue number10
DOIs
StatePublished - Oct 1992
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology

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