Zubler F, Seeck M, Landis T, Henry F, Lazeyras F
Laboratory for Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Programme of the Universities Lausanne and Geneva, Switzerland.
J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1240-4. doi: 10.1136/jnnp.74.9.1240.
Proton magnetic resonance spectroscopy (MRS) of the hippocampus is useful in lateralising the epileptic focus in temporal lobe epilepsy for subsequent surgical resection. Previous studies have reported abnormal contralateral MRS values in up to 50% of the patients.
To identify the contributing factors to contralateral damage, as determined by MRS, and its extension in patients with temporal lobe epilepsy.
Single voxel MRS was carried out in the hippocampus and lateral temporal neocortex of both hemispheres in 13 patients with left temporal lobe epilepsy (LTLE) and 16 patients with right temporal lobe epilepsy (RTLE). All patients had mesial temporal lobe epilepsy with hippocampal sclerosis. Controls were 21 healthy volunteers of comparable age.
Consistent with previous studies, the NAA/(Cho+Cr) ratio was abnormally low in the hippocampus ipsilateral to the focus (p < 0.0001), and there were lower values in both patient groups in the ipsilateral temporal neocortex (p < 0.0001). Patients with RTLE had left hippocampal MRS anomalies (p = 0.0018), whereas the right hippocampus seemed to be undamaged in LTLE patients.
Unilateral mesial temporal lobe epilepsy is associated with widespread metabolic abnormalities which involve contralateral mesial and neocortical temporal lobe structures. These abnormalities appear to be more pronounced in patients with RTLE.
海马体的质子磁共振波谱（MRS）有助于确定颞叶癫痫的癫痫病灶侧别，以便后续进行手术切除。既往研究报道，高达50%的患者对侧MRS值异常。
确定MRS所判定的对侧损害的相关因素及其在颞叶癫痫患者中的扩展情况。
对13例左侧颞叶癫痫（LTLE）患者和16例右侧颞叶癫痫（RTLE）患者双侧海马体及颞叶外侧新皮质进行单体素质子磁共振波谱检查。所有患者均患有内侧颞叶癫痫伴海马硬化。对照组为21名年龄相仿的健康志愿者。
与既往研究一致，病灶同侧海马体的NAA/（Cho+Cr）比值异常低（p<0.0001），且两组患者同侧颞叶新皮质的值均较低（p<0.0001）。RTLE患者左侧海马体有MRS异常（p=0.0018），而LTLE患者右侧海马体似乎未受损。
单侧内侧颞叶癫痫与广泛的代谢异常有关，这些异常累及对侧内侧及新皮质颞叶结构。这些异常在RTLE患者中似乎更为明显。
