The Use of Magnetic Resonance Spectroscopy in the Evaluation of Epilepsy

Caruso, Paul; Johnson, Jason M.; Thibert, Ron; Rapalino, Otto; Rincon, Sandra; Ratai, Eva

doi:10.1016/j.nic.2012.12.012

Cited by 23 publications

(10 citation statements)

References 88 publications

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“…Single-photon emission-computed tomography (SPECT) compares local blood flow discrepancies, information that is most useful when recorded during a seizure. Magnetoencephalography (MEG) assesses the brain's dynamic electromagnetic fields and can better localize epileptic dipoles, including those tangential to the scalp, which can be missed by conventional EEG (Caruso et al 2013). These advanced modalities are used mainly in epilepsy centers for presurgical evaluations (Kay and Szaflarski 2014).…”

Section: Neuroimagingmentioning

confidence: 99%

Seizures and Epilepsy: An Overview for Neuroscientists

Stafstrom

Carmant²

2015

Cold Spring Harbor Perspectives in Medicine

651

421

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Epilepsy is one of the most common and disabling neurologic conditions, yet we have an incomplete understanding of the detailed pathophysiology and, thus, treatment rationale for much of epilepsy. This article reviews the clinical aspects of seizures and epilepsy with the goal of providing neuroscientists an introduction to aspects that might be amenable to scientific investigation. Seizures and epilepsy are defined, diagnostic methods are reviewed, various clinical syndromes are discussed, and aspects of differential diagnosis, treatment, and prognosis are considered to enable neuroscientists to formulate basic and translational research questions.T his article provides an overview of seizures and epilepsy for neuroscientists. We focus on broad concepts, rather than clinical details, and raise questions related to mechanisms, epileptogenesis, and therapeutic approaches that might generate interest among basic researchers. Further information about differential diagnosis, drug doses, and clinical management are available from numerous resources (Engel and Pedley 2008;Duchowny et al. 2012;Engel 2013).We first define seizures and epilepsy and summarize their classification, pathophysiology, and genetics. Diagnostic methods are then considered, including the importance of an accurate historical description of an event suspected to be a seizure and the appropriate use of ancillary/confirmative tests, such as electroencephalogram (EEG), neuroimaging, and genetic studies. These modalities enable the clinician to differentiate epilepsy from numerous clinical conditions that mimic seizures, but have a nonepileptic pathophysiological basis. Examples of epilepsy syndromes are then described, selected based on their frequency in the population or because they embody scientific questions that warrant elucidation. Finally, we provide an overview of treatment options and prognosis, including a consideration of conditions that accompany epilepsy (comorbidities) and complicate the daily lives of people with epilepsy. Subsequent articles in this collection explore the scientific basis of many of the clinical concepts introduced here. DEFINITIONS AND EPIDEMIOLOGYA "seizure" is a paroxysmal alteration of neurologic function caused by the excessive, hyper-

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Section: Neuroimagingmentioning

confidence: 99%

Seizures and Epilepsy: An Overview for Neuroscientists

Stafstrom

Carmant²

2015

Cold Spring Harbor Perspectives in Medicine

651

421

View full text Add to dashboard Cite

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“…Different techniques including monovoxel or multivoxel studies have been used for the characterization of brain tumors, as well as for other pathologies, including leucodystrophies, metabolic disorders (Figure 1) or HS. MRS can also be useful in identifying the side of the epileptogenic focus in cases of temporal lobe epilepsy, demonstrating decreased N-acetyl aspartate (NAA) to creatine (Cr) ratio or NAA to choline (Cho) ratio in the pathologic site [56,57], frequently before morphological changes become apparent in conventional imaging.…”

Section: Morphological Imaging In Epilepsymentioning

confidence: 99%

Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

et al. 2019

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The etiology of epilepsy is variable and sometimes multifactorial. Clinical course and response to treatment largely depend on the precise etiology of the seizures. Along with the electroencephalogram (EEG), neuroimaging techniques, in particular, magnetic resonance imaging (MRI), are the most important tools for determining the possible etiology of epilepsy. Over the last few years, there have been many developments in data acquisition and analysis for both morphological and functional neuroimaging of people suffering from this condition. These innovations have increased the detection of underlying structural pathologies, which have till recently been classified as “cryptogenic” epilepsy. Cryptogenic epilepsy is often refractory to anti-epileptic drug treatment. In drug-resistant patients with structural or consistent functional lesions related to the epilepsy syndrome, surgery is the only treatment that can offer a seizure-free outcome. The pre-operative detection of the underlying structural condition increases the odds of successful surgical treatment of pharmacoresistant epilepsy. This article provides a comprehensive overview of neuroimaging techniques in epilepsy, highlighting recent advances and innovations and summarizes frequent etiologies of epilepsy in order to improve the diagnosis and management of patients suffering from seizures, especially young patients and children.

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“…In this study, we used short (30 ms) and long (135 ms) TE. As short TE allowed us to detect more metabolites especially myo-inositol and glutamates, As the change of their levels found to be related to poor outcome in some cases [18]. We also used long TE because the attenuation of the signal from the metabolites with shorter time of relaxation (TR), improves the signalnoise ratio of the main three metabolites (NAA, Cho, and Cr), and allowed better calculation of the ratios [19].…”

Section: Discussionmentioning

confidence: 99%

“…One protocol was to survey white matter, deep and cortical grey matter by using 3 voxels-using short TE of 35 ms-over the centrum semiovale, lentiform nuclei, and midline occipito-parietal cortex. Another protocol was using one voxel over the basal ganglia in order to save time [18]. In the present study, we went with Caruso's first protocol, we placed one voxel in the left centrum semiovale, one in the left lentiform nucleus, and one in the midline parietooccipital region.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic role of proton single-voxel spectroscopy (SVS) in non-lesional epilepsy pediatric patients: prospective controlled study

Faheem

Dabour

Abdelhaie

2020

Egypt J Radiol Nucl Med

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Background: We aimed to verify the diagnostic and prognostic role of proton single-voxel spectroscopy (SVS) in children with non-lesional epilepsy and its add-on value to conventional MR. The prospective controlled study carried out on the epileptic patients who were regularly following in the pediatric neurology clinic in our university hospital, over the period from July 2017 to July 2018. It compared SVS findings (NAA/Cr, NAA/Cho, and NAA/ Cho+Cr ratios) between the case (50 patients) and control group (20 children), between the cases with different seizures semiology and between the patients with intractable and non-intractable epilepsy. Results: NAA/Cr ratio showed a significant difference between the patients with intractable and non-intractable epilepsy in the basal ganglia (P value 0.005) and white matter (P value 0.043) with cutoff values of 1.5 and 1.9 respectively. A significant difference of NAA/Cho ratio was found between generalized seizures cases and other seizures semiology in basal ganglia (P value 0.012) and cortex (P value <.001). There was no significant difference between the patient and control groups or between generalized seizures cases and the control group. Conclusion: Proton SVS has limited diagnostic value in non-lesional epilepsy pediatric patients, in differentiation between generalized seizures and other seizure types, but, it has a good prognostic role in predicting patients who will develop intractable epilepsy.

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The Use of Magnetic Resonance Spectroscopy in the Evaluation of Epilepsy

Cited by 23 publications

References 88 publications

Seizures and Epilepsy: An Overview for Neuroscientists

Seizures and Epilepsy: An Overview for Neuroscientists

Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

Diagnostic and prognostic role of proton single-voxel spectroscopy (SVS) in non-lesional epilepsy pediatric patients: prospective controlled study

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