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Children with intractable temporal and extratemporal seizures: Correlation of the MR spectroscopy and EEG findings in the surgical planning

M.M. Arnaout, S.S. Desoky, I.A. Lebda, A.A. Bessar, M.I. Fathy, E.H. Zidan, H.A. Hassan (Zagazig, Egypt)

Meeting: 2016 International Congress

Abstract Number: 1181

Keywords: Magnetic resonance imaging(MRI)

Session Information

Date: Wednesday, June 22, 2016

Session Title: Neuroimaging (non-PD)

Session Time: 12:00pm-1:30pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To show the value of MR spectroscopy in detecting metabolite ratios dysfunction and in lateralizing the epileptogenic focus in agreement with EEG in children with intractable seizures.

Background: MR spectroscopy helps to assess the metabolic changes in the epileptic brain focus and could be used to lateralize the epileptic focus.

Methods: A total number of 50 pediatric patients (43 females and 27 males) with average age 7.5 years. The duration of the disease illness at time of performing the MRI & MRS studies varied from 1 year to 15 years. The study was conducted over a period of 34 months with all children with temporal and extra-temporal intractable epilepsy were scheduled for MRI and MR spectroscopy of the temporal and extra-temporal regions on both sides. Lateralization by MRS was compared to that by the EEG and MRI studies. Calculation of the metabolite ratios was done for detection of abnormal metabolite ratios concordant with the side of epileptic activity as detected by the EEG and MRI.

Results: 26 patients did not show abnormality on conventional MR imaging (52% of total patient number), and these were referred to negative MR cases in this study. There was a correlation between MRS to EEG by 92% in temporal epilepsy and 61% In extratemporal epilepsy, 88% in both temporal and extratemporal epilepsies. Proton MRS revealed the bilateral metabolic abnormalities in 6 of our patients with unilateral EEG focus(14% of unilateral cases). Metabolic abomalties were severe on the side of EEG lateralization on all our bilateral cases. Our study revealed that MRS can accurately lateralize the side of maximum affection in 88% of cases.

Conclusions: : MR spectroscopy allows non-invasive correct lateralization of the epileptic focus concordant with the EEG and MRI lateralization both in temporal and extra-temporal pediatric epilepsy. MRS can also detect abnormal metabolite ratios in MR negative patients with EEG lateralization.

To cite this abstract in AMA style:

M.M. Arnaout, S.S. Desoky, I.A. Lebda, A.A. Bessar, M.I. Fathy, E.H. Zidan, H.A. Hassan. Children with intractable temporal and extratemporal seizures: Correlation of the MR spectroscopy and EEG findings in the surgical planning [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/children-with-intractable-temporal-and-extratemporal-seizures-correlation-of-the-mr-spectroscopy-and-eeg-findings-in-the-surgical-planning/. Accessed May 12, 2025.
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