Pa. Garcia et al., PHOSPHORUS MAGNETIC-RESONANCE SPECTROSCOPIC IMAGING IN PATIENTS WITH FRONTAL-LOBE EPILEPSY, Annals of neurology, 35(2), 1994, pp. 217-221
Phosphorus magnetic resonance spectroscopic imaging has previously dem
onstrated localized metabolic abnormalities within the epileptogenic r
egion in patients with temporal lobe epilepsy, including alkalosis, in
creased inorganic phosphate level, and decreased phosphomonoester leve
ls. We studied 8 patients with frontal lobe epilepsy, finding interict
al alkalosis in the epileptogenic region compared to the contralateral
frontal lobe in all patients (7.10 +/- 0.05 vs 7.00 +/- 0.06, P < 0.0
01). Seven patients exhibited decreased phosphomonoester levels in the
epileptogenic frontal lobe compared to the contralateral frontal lobe
(16.0 +/- 6.0 vs 23.0 +/- 4.0, P < 0.01). In contrast to findings in
temporal lobe epilepsy, inorganic phosphate level was not increased in
the epileptogenic region. Based on values derived from normal control
subjects, 5 patients had elevated pH in the seizure focus and 2 patie
nts had decreased phosphomonoesters while none had abnormalities in th
e contralateral frontal lobe. These data suggest that magnetic resonan
ce spectroscopy will be useful in the presurgical evaluation of patien
ts with frontal lobe epilepsy.