MR imaging in patients with temporal lobe seizures: correlation of results with pathologic findings.

Journal Article

Thirty-nine consecutive patients with medically intractable complex partial seizures were studied with electroencephalography and MR imaging to localize an epileptogenic focus for temporal lobectomy. The patients were divided into three groups on the basis of pathologic findings after lobectomy: Group 1 comprised 13 patients with neoplasms, hamartomas, or cysts; group 2 comprised 13 patients with moderate and severe mesial temporal sclerosis (one patient was included in both groups 1 and 2); and group 3 comprised 14 patients who underwent aspiration lobectomy, which yielded limited tissue for pathologic study so no pathologic diagnosis was made. The majority of the patients in group 3 were assumed to have mesial temporal sclerosis. Abnormal MR signal in the temporal lobe on T2-weighted images was graded as minimal increase (1+), intermediate or moderate increase (2+), and very significant increase (3+). An abnormal signal was demonstrated in 26 (67%) of the 39 patients. In group 1, the tumor/cyst subgroup, an abnormal signal was seen in all 13 patients. Most had 3+ signal. There was increased signal in eight (62%) of 13 patients in group 2 and in six (43%) of 14 patients in group 3. This study suggests that MR can detect almost all tumors and a significant number of mesial temporal sclerosis lesions in individuals with complex partial seizures. On the basis of this small series, individuals who exhibit significant signal (3+) can be expected to have neoplasms, hamartomas, or cysts, and patients who exhibit minimal signal (1+) will usually have mesial temporal sclerosis.

Full Text

Duke Authors

Cited Authors

  • Heinz, ER; Crain, BJ; Radtke, RA; Burger, PC; Friedman, AH; Djang, WT; Wilkinson, WE

Published Date

  • September 1990

Published In

Volume / Issue

  • 155 / 3

Start / End Page

  • 581 - 586

PubMed ID

  • 2117360

International Standard Serial Number (ISSN)

  • 0361-803X

Digital Object Identifier (DOI)

  • 10.2214/ajr.155.3.2117360

Language

  • eng

Conference Location

  • United States