QUALITATIVE MRI SEGMENTATION IN MESIAL TEMPORAL SCLEROSIS - CLINICAL CORRELATIONS

Magnetic resonance imaging (MRI) is reliable and sensitive in the dete ction of mesial temporal atrophy in patients with temporal lobe epilep sy. We investigated the MRI patterns of atrophy in 47 patients with hi stologically confirmed hippocampal sclerosis and correlated the imagin g findings to the clinical features and surgical outcome. One hundred percent of patients had hippocampal body atrophy, 70% had hippocampal tail atrophy, 23% had amygdala atrophy, and 10% had focal hippocampal body atrophy without other segmental involvement. Correlative analysis of the segmented MRT findings with other clinical variables, includin g a previous history of childhood febrile convulsions, showed no signi ficant associations except for younger age of seizure onset associated with hippocampal tail atrophy (p < 0.03). No associations between sur gical outcome and the patterns of mesial temporal atrophy were detecte d. Our results demonstrate that variable patterns of atrophy exist in mesial temporal atrophy, but invariably atrophy involves the hippocamp al body segment. Segmental MRI analysis in mesial temporal atrophy pro vides added useful diagnostic information.