Clinical Applications Of Proton Magnetic Resonance Spectroscopy In Children With Febrile Seizure And Epilepsy

ObjectiveTo investigate the applications of proton magnetic resonance spectroscopy (1H-MRS) in detecting the biochemical metabolism in children with febrile seizure and epilepsy, and to evaluate the information of brain injury and approach the clinical significance of 1H-MRS in febrile and epilepsy.MethodsIn 41 cases of children with convulsions, 25 were febrile seizure (15 cases of children with complex febrile seizure and 10 cases with simple febrile seizure), 16 were epilepsy (7 cases of epilepsy children with history of FS and 9 cases without FS history), and 6 cases without nervous system disease were control. All 47 cases were exprienced MRI examinations of skull and Single-voxel 1H-MRS examinations of the hippocampi-temporal lobe. The signal intensities of N-acetylaspartate (NAA),eatine+phosphocreatine (Cr),choline-containig compounds (Cho),glutamate+glutamine (Glx),Lactate (Lac) and the ratios of NAA/ (Cho＋Cr) and Lac/Cr were set into comparison between the patients and controls.ResultsThe study showed that all children investigated by MRI were normal except one child with epilepsy who had dysdeveloped myelin. The ratio of NAA/(Cho＋Cr) in SFS patients was 0.71±0.05, CFS patients was 0.65±0.04, EP patients was 0.62±0.04 (epilepsy children with history of FS was 0.60±0.03 and epilepsy children without FS history was 0.64±0.04), control group was 0.73±0.05. No significant differences was observed in NAA/(Cho＋Cr) between CFS group and EP (P＞0.05), but NAA/(Cho＋Cr) in the two groups were lower than that in controls (P＜0.01). The NAA/(Cho＋Cr) ratio in CFS group was lower than that in SFS and control group (P＜0.01), but no significant difference was found between SFS and control group (P＞0.05). The ratio ofNAA/ (Cho＋Cr) in epilepsy children with history of FS was lower than those in epilepsy children without FS history (P＜0.05) . As to the ratio of Lac/Cr, in the patients of SFS group (0.32±0.21) and CFS group (0.65±0.30) were higher than that in the patients of the control group (0.05±0.04) and EP group (0.11±0.09) (P＜0.05), and Lac/Cr ratio in the patients of CFS group was higher than that in SFS group (P＜0.01), whereas there was no significant difference was found between control and EP group.Conclusions1. The ratio of NAA/(Cho＋Cr), as a marker of neuronal damage, which decreased in CFS children in the study. It may reflect the loss or dysfunction of neurons in the patients with CFS and EP.2. The ratio of Lac/Cr, as a marker of acute ischemia, which increased in the patients with SFS and CFS. It may indicate brain ischemia during seizures and brain injury even after trainsient seizures.3. 1H-MRS could provide earlier information on brain injury sensitively and noninvasively in children with EP and FS. And it may be used for therapy and prognosis in children with FS and EP.