DIAGNOSIS OF MEDIAL TEMPORAL-LOBE SEIZURE ONSET - RELATIVE SPECIFICITY AND SENSITIVITY OF QUANTITATIVE MRI

被引:146
作者
SPENCER, SS
MCCARTHY, G
SPENCER, DD
机构
[1] YALE UNIV, SCH MED, DEPT SURG, NEW HAVEN, CT 06510 USA
[2] VET ADM MED CTR, West Haven, CT 06516 USA
关键词
D O I
10.1212/WNL.43.10.2117
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Measurement of hippocampal volume by MRI is a new technique with potentia value in the localization of epileptic regions, but whether reduced hippocampal volume predicts the location of electrical seizure onset in mixed patient groups is not known. We examined the sensitivity and specificity of this technique among 56 refractory epileptic patients for the diagnosis of medial temporal lobe epilepsy as judged by intracranial EEG recording of spontaneous seizure onset. Since these patients had intracranial EEG because of inconsistent or insufficient localization by noninvasive electrophysiologic, functional, and structural assessment, this patient population can be considered the most difficult to localize. Hippocampal atrophy by MRI volumetry was 75% sensitive to, and 64% specific for, ipsilateral medial temporal lobe seizure onset in this group. Hippocampal atrophy was significantly correlated with longer duration of epilepsy. MRI compared favorably with all other noninvasive means of localization, which had 41 to 73% sensitivity and 45 to 65% specificity to medial temporal ictal onset; of these, none had as acceptable a combination of both adequate sensitivity and specificity. We conclude that MRI volumetry of the hippocampus is a valuable, noninvasive localization method in chronic epilepsy, with a yield and accuracy surpassing all other noninvasive studies used to predict the presence of medial temporal seizure onset.
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页码:2117 / 2124
页数:8
相关论文
共 31 条
[1]   HIPPOCAMPAL SCLEROSIS IN TEMPORAL-LOBE EPILEPSY DEMONSTRATED BY MAGNETIC-RESONANCE-IMAGING [J].
BERKOVIC, SF ;
ANDERMANN, F ;
OLIVIER, A ;
ETHIER, R ;
MELANSON, D ;
ROBITAILLE, Y ;
KUZNIECKY, R ;
PETERS, T ;
FEINDEL, W .
ANNALS OF NEUROLOGY, 1991, 29 (02) :175-182
[2]   MRI IN THE PRESURGICAL EVALUATION OF PATIENTS WITH FRONTAL-LOBE EPILEPSY AND CHILDREN WITH TEMPORAL-LOBE EPILEPSY - PATHOLOGICAL CORRELATION AND PROGNOSTIC IMPORTANCE [J].
CASCINO, GD ;
JACK, CR ;
PARISI, JE ;
MARSH, WR ;
KELLY, PJ ;
SHARBROUGH, FW ;
HIRSCHORN, KA ;
TRENERRY, MR .
EPILEPSY RESEARCH, 1992, 11 (01) :51-59
[3]   MAGNETIC-RESONANCE IMAGING-BASED VOLUME STUDIES IN TEMPORAL-LOBE EPILEPSY - PATHOLOGICAL CORRELATIONS [J].
CASCINO, GD ;
JACK, CR ;
PARISI, JE ;
SHARBROUGH, FW ;
HIRSCHORN, KA ;
MEYER, FB ;
MARSH, WR ;
OBRIEN, PC .
ANNALS OF NEUROLOGY, 1991, 30 (01) :31-36
[4]   MAGNETIC-RESONANCE-IMAGING-BASED VOLUME STUDIES IN PATIENTS WITH BITEMPORAL EPILEPTIFORM ABNORMALITIES [J].
CASCINO, GD ;
JACK, CR ;
SHARBROUGH, FW ;
KELLY, PJ ;
MARSH, WR .
JOURNAL OF EPILEPSY, 1992, 5 (04) :210-213
[5]   HIPPOCAMPAL VOLUMETRIC AND MORPHOMETRIC STUDIES IN FRONTAL AND TEMPORAL-LOBE EPILEPSY [J].
COOK, MJ ;
FISH, DR ;
SHORVON, SD ;
STRAUGHAN, K ;
STEVENS, JM .
BRAIN, 1992, 115 :1001-1015
[6]  
DIAZ-ARRASTIA R, 1992, Neurology, V42, P206
[7]   MAGNETIC-RESONANCE-IMAGING OF INTRACTABLE COMPLEX PARTIAL SEIZURES - PATHOLOGICAL AND ELECTROENCEPHALOGRAPHIC CORRELATION [J].
DOWD, CF ;
DILLON, WP ;
BARBARO, NM ;
LAXER, KD .
EPILEPSIA, 1991, 32 (04) :454-459
[8]   FOCAL CEREBRAL-LESIONS FOUND BY MAGNETIC-RESONANCE IMAGING IN CRYPTOGENIC NONREFRACTORY TEMPORAL-LOBE EPILEPSY PATIENTS [J].
FRANCESCHI, M ;
TRIULZI, F ;
FERINISTRAMBI, L ;
GIUSTI, MC ;
MINICUCCI, F ;
FAZIO, F ;
SMIRNE, S ;
DELMASCHIO, A .
EPILEPSIA, 1989, 30 (05) :540-546
[9]  
HEINZ ER, 1988, AM J NEURORADIOL, V9, P1123
[10]   MR-BASED HIPPOCAMPAL VOLUMETRY IN THE DIAGNOSIS OF ALZHEIMERS-DISEASE [J].
JACK, CR ;
PETERSEN, RC ;
OBRIEN, PC ;
TANGALOS, EG .
NEUROLOGY, 1992, 42 (01) :183-188