Correlation Of Seizure With Metabolic Dysfunction In Hippocampus By 1~h-magnetic Resonance Imaging In Chronic Temporal Lobe Epilepsy

Objective To explore the correlation between seizure and metabolic dysfunction of neuron and glia cell in the hippocampus in chronic temporal lobe epilepsy (cTLE); and to improve our understanding of progressive changes and the underlying mechanisms in the chronic temporal lobe epilepsy. Methods and Materials 41 patients were diagnosed as cTLE by comprehensive use of clinical history and neurological examination, scalp EEG with sphenoidal electrodes, conventional magnetic resonance imaging (cMRI); and then multiple-voxel MR chemical shift imaging was performed. There were 21 men and 20 women with the age of 8 to 56 years (mean age, 24±22 years). 20 healthy volunteers with known history of no neurological disease were recruited as control. An analysis was performed in the correlation of seizure and duration with the ratio of NAA/ (Cho+Cr) in the hippocampus ipsilateral to epileptogenesis foci and contralateral to epileptogensis foci. Moreover, and then the patients were devided into two groups according to the seizure frequency (≥1 per month,<1 per month), the difference of the ratio of NAA/(Cho+Cr) in the hippocampus was investigated between the two groups. Results The ratio of NAA/ (Cho+Cr) tended to increase along both hippocampi in the posteroanterior direction in patients with cTLE and in the control. The ratio of NAA/ (Cho+Cr) was significantly decreased in the head, body and tail of the hippocampus in the cTLE compared to the control group. But in the cTLE patients, no significant correlation was found between the seizure and duration and the ratio of NAA/(Cho+Cr) in the hippocampus ipsilateral to epileptogensis foci, and neither was in the hippocampus contralateral to epileptogensis foci; The ratio of NAA/(Cho+Cr) in the head of the hippocampus ipsilateral to the epileptogensis foci was significantly lower in the group of seizure frequency with more than once per month than the group with less than once per month (P<0.05). And no significant difference found in the body and tail of the hippocampus ipsilateral to the epilepogensis foci. Conclusions In the chronic temporal lobe epilepsy, our findings suggested that neuronal cell loss or dysfunction may occur in the hippocampus ipsilateral to the epileptogensis foci, but the worsening of epilepsy disease was not in agree with the seizure frequency and the duration of epilepsy history, which may imply that the chronic temporal epilepsy was not a progressive disease.