Nonrefractory temporal lobe epilepsy: 1.5-T MR imaging.

Thirty-one patients with temporal lobe epilepsy (TLE) of mild to moderate severity, well controlled by pharmacotherapy (nonrefractory TLE), and with negative findings at computed tomography, were studied with magnetic resonance (MR) imaging at 1.5 T. Examination disclosed significant findings in 16 patients: mesial temporal abnormalities (n = 9), basitemporal abnormalities (n = 2), and alterations in frontoparietal white matter (n = 5). Coronal views and sequences with a 120-msec echo time (TE) depicted lesions in 16 patients; axial views depicted lesions in only nine of 16 patients; sequences with a 35-msec TE depicted lesions in only ten. These results underline the importance of screening with MR imaging in nonrefractory TLE patients and suggest that the MR imaging sequence of choice is a thin-section, coronal, T2-weighted sequence.