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Value of magnetic resonance imaging-based measurements of hippocampal formations in patients with partial epilepsy.
Adam, C; Baulac, M; Saint-Hilaire, J M; Landau, J; Granat, O; Laplane, D.
Afiliação
  • Adam C; Hôpital de la Salpêtrière, Clinique des Maladies du Système Nerveux, Paris, France.
Arch Neurol ; 51(2): 130-8, 1994 Feb.
Article em En | MEDLINE | ID: mdl-8304837
ABSTRACT

OBJECTIVE:

To determine the occurrence of magnetic resonance imaging-detected hippocampal atrophy (HA) in patients with partial epilepsy (temporal and extratemporal, cryptogenic, or symptomatic). Magnetic resonance imaging-detected HA has been demonstrated to be both sensitive and specific for hippocampal sclerosis in cryptogenic temporal lobe epilepsy.

DESIGN:

Patients' hippocampal formations were measured on a computerized system using T1-weighted, 5-mm contiguous magnetic resonance coronal images made perpendicular to the hippocampus long axis. Hippocampal atrophy was defined on the basis of a normative asymmetry index and correlated with the epileptogenic focus defined by clinical, electroencephalographic, and magnetic resonance imaging (apart from HA) localizing data. PATIENTS AND CONTROL

SUBJECTS:

Seventy patients with intractable complex partial seizures of temporal, extratemporal, or undefined origin and 21 healthy control subjects.

RESULTS:

Hippocampal atrophy was present in 70% of patients with cryptogenic temporal lobe epilepsy (TLE) (n = 40), 44% of patients with symptomatic TLE (n = 9), 29% of patients with extratemporal epilepsy (n = 14), and 6% of unclassified patients (n = 16). In the cryptogenic TLE category, HA was marked and usually concordant (93%) with electroencephalographic lateralization. Hippocampal atrophy was often mild in the extratemporal epilepsy category. With the use of a wider confidence interval (+/- 3.1 SD instead of +/- 2.2 SD), HA specificity for TLE increased to 93%, HA specificity for lateralizing cryptogenic TLE reached 96%, and HA sensitivity for cryptogenic TLE stood almost unchanged (68%). We found a link between early convulsions and HA occurrence.

CONCLUSIONS:

Hippocampal atrophy is a marker for TLE. Dual pathologic findings are detected in 44% of symptomatic TLE cases. Mild HA is rarely associated with extratemporal epilepsy. Magnetic resonance imaging-based hippocampal volumetric analysis is a useful method to localize the origin of partial complex seizures.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Epilepsias Parciais / Hipocampo Limite: Adult / Humans / Middle aged Idioma: En Revista: Arch Neurol Ano de publicação: 1994 Tipo de documento: Article País de afiliação: França
Buscar no Google
Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Epilepsias Parciais / Hipocampo Limite: Adult / Humans / Middle aged Idioma: En Revista: Arch Neurol Ano de publicação: 1994 Tipo de documento: Article País de afiliação: França