Epilessia del lobo temporale farmaco-resistente: Alterazioni metaboliche dell'ippocampo evidenziate mediante spettroscopia singe-voxel (1HMRS) con RM 3 Tesla

Proton magnetic resonance Spectroscopy (1H-MRS) of hippocampal regions might provide lateralizing informations in the presurgical evaluation of patients with drug-resistant temporal lobe epilepsy (TLE) [1-4]. From December 2005 until now we performed 3T 1H-MRS on bilateral hippocampal regions in 20 patients suffering from intractable TLE associated with hippocampal sclerosis (HS). All patients underwent surgery; pathological examination of surgical specimens demonstrated MTS in all cases, with cortical dysplasia in some. The tNAA/Cr, tNAA/Cho, tCho/Cr, mI/Cr, Glx/Cr ratio were calculated and compared with data collected from 12 healthy volunteers. Data from patients versus normal subjects, and data from the affected hippocampus versus the healty contralateral, one were compared and statistically evaluated (Mann-Whitney's test). Our study demonstrates concordance between increased hippocampal mI/Cr ratio and pathological hippocampus [5]; an additional interesting finding was the bilateral reduction of hippocampal NAA/Cr ratio as compared to normals, suggesting metabolic abnormalities in both hippocampuses [3-4].