HIPPOCAMPAL VOLUMETRIC AND MORPHOMETRIC STUDIES IN FRONTAL AND TEMPORAL LOBE EPILEPSY

The most common temporal lobe pathology is Ammons Horn sclerosis (AHS), and several different imaging techniques have been utilized to detect this with varying success We describe the clinical application of magnetic resonance imaging (MRI) using a three-dimensional volume technique which allows tot...

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Bibliographic Details
Published in:Brain (London, England : 1878) England : 1878), 1992-08, Vol.115 (4), p.1001-1015
Main Authors: COOK, M. J., FISH, D. R., SHORVON, S. D., STRAUGHAN, K., STEVENS, J. M.
Format: Article
Language:English
Subjects:
Adult
Amygdala - pathology
Biological and medical sciences
Epilepsy - pathology
Epilepsy, Temporal Lobe - pathology
Female
Frontal Lobe - pathology
Hippocampus - pathology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging
Male
Medical sciences
Radiodiagnosis. Nmr imagery. Nmr spectrometry
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Summary:The most common temporal lobe pathology is Ammons Horn sclerosis (AHS), and several different imaging techniques have been utilized to detect this with varying success We describe the clinical application of magnetic resonance imaging (MRI) using a three-dimensional volume technique which allows total hippocampal volume to be measured and symmetry evaluated. Hippocampal surface area was calculated in sequential 1.5 mm thick contiguous images, using a GE IC workstation. Total volumes and surface areas were calculated. The cross-sectional surface area at 1 5 mm intervals was displayed graphically, permitting morphometric analysis of the hippocampus throughout its length. Focal atrophy within any part of the hippocampal formation (HF) and its extent could thus be assessed. Patients with well-lateralized temporal lobe epilepsy (TLE) (n = 20) and well-defined frontal lobe epilepsy (FLE) (n = 20) were studied, and volumes compared with normal values derived from 10 neurologically normal controls Asymmetric hippocampal volume loss was demonstrated in all 20 patients with clinically typed TLE, but not in normal controls or patients with FLE. Volume loss distribution was anterior in 12 patients, posterior in one patient and widespread in seven patients. Secondarily generalized seizures were strongly associated with widespread loss. This method of surface area and volumetric analysis of the hippocampus in TLE can demonstrate asymmetry and focal involvement, and help distinguish between hippocampal and frontal pathologies
ISSN:0006-8950
1460-2156
DOI:10.1093/brain/115.4.1001