The Value of Diffusion-Weighted Magnetic Resonance Imaging in Patients with Mesial Temporal Lobe Epilepsy

[摘要] Background: Seizures are common neurological problems. Complex partial seizures of temporal lobe origin represent the most common type of refractory epilepsy and proper management necessitates proper localization of the seizure focus. Objective: To evaluate the possible role of interictal DWI in lateralizing mesial temporal lobe epilepsy in patients with normal conventional MR scans. Methods: The study was conducted on 30 Egyptian patients with temporal lobe epilepsy (TLE) with a mean age of 27.3±9.7 years and 10 healthy controls with a mean age of 26±7.6. They were subjected to thorough clinical assessment, conventional interictal EEG, neuropsychological assessment using Rey-Osterrieth complex figure test (RCFT), MRI of the brain and interictal diffusion MRI of the brain. Results: Ipsilateral and mean hippocampal ADC values were significantly higher in patients with TLE compared to healthy controls. Ipsilateral hippocampal ADC values were higher compared to contralateral hippocampus. The most sensitive test for diagnosis of TLE was diffusion MRI b500 (100%) followed by diffusion MRI b500 (70%), and the least sensitive was EEG (33.3%). Conclusion: Interictal hippocmpal diffusion MRI proved to be a highly sensitive tool for the precise localization of the seizure focus in TLE patients. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(3): 305-310]

[学科分类] 精神健康和精神病学