TEMPORAL-LOBE EPILEPSY - CORRELATION OF PROTON MAGNETIC-RESONANCE SPECTROSCOPY AND F-18 FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY

Proton magnetic resonance spectroscopy (MRS) has demonstrated reductio n of N-acetylaspartate (NAA) in the epileptogenic temporal robe. Howev er, the correlation of NAA reduction with cerebral metabolic abnormali ties is unknown in temporal robe epilepsy (TLE). Proton MRS and F-18-f luorodeoxyglucose positron emission tomography (FDG/PET) were used to study 12 unilateral TLE patients with medically intractable seizures a nd 26 age-matched healthy volunteers. The epileptogenic temporal lobe of each patient was determined by both electroencephalography and FDG/ PET. The NAA/choline-plus-creatine (NAA/(Cho + Cr)) ratio correlated s ignificantly with the interictal glucose metabolism (r = 0.54, P < 0.0 1) in 12 TLE patients. The mean NAA/(Cho + Cr) ratio in the epileptoge nic temporal robe was significantly less than that in the contralatera l side (P < 0.01), and less than that in normal control temporal robes (P < 0.0001). These results suggest that quantitative MRS abnormaliti es reflect underlying metabolic pathology in TLE.