Seizure-associated abnormalities in epilepsy: Evidence from MR imaging

Acute seizure-associated changes have been described in the animal and human literature. Controversy exists over whether seizures cause permanent damage to the brain, and whether a (prolonged) seizure can induce changes that lead to an epileptic lesion, resulting in habitual seizures and epilepsy. Current magnetic resonance imaging (MRI) offers a variety of imaging tools and is capable of detecting acute seizure-associated changes. In contrast to the histologic examination, serial MRI studies are possible and allow longitudinal observation of the fate of these changes. This report reviews the literature on acute seizure-associated effects emphasizing the MRI evidence

Magnetic resonance spectroscopy in epilepsy

Key points \ud • The clinical aims of MR spectroscopy (MRS) in \ud seizure disorders are to help identify, localize \ud and characterize epileptogeic foci. \ud • Lateralizing MRS abnormalities in temporal lobe \ud epilepsy (TLE) may be used clinically in combi- \ud nation with structural and T2measurements. \ud • Characteristic metabolite abnormalities are \ud decreased N-acetylaspartate (NAA) with \ud increased choline (Cho) and myoinositol (mI) \ud (short-echo time). \ud • Contralateral metabolite abnormalities are \ud frequently seen in TLE, but are of uncertain \ud significance. \ud • In extra-temporal epilepsy, metabolite abnor- \ud malities may be seen where MR imaging (MRI) \ud is normal; but may not be sufficiently local- \ud ized to be useful clinically. \ud • MRS may help to characterize epileptogenic \ud lesions visible on MRI (aggressive vs. indolent \ud neoplastic, dysplasia). \ud • Spectral editing techniques are required to \ud evaluate specific epilepsy-relevant metabolites \ud (e.g. -aminobutyric acid (GABA)) which may \ud be useful in drug development and evaluation. \ud • MRS with phosphorus (31P) and other nucleii \ud probe metabolism of epilepsy, but are less \ud useful clinically

Magnetic resonance spectroscopy: Principles and techniques-Biochemistry for magnetic resonance spectroscopy: Clinical applications of magnetic resonance spectroscopy in epilepsy

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Seizure dependent language lateralization demonstrated using fMRI

Abstract not available