Proton MR spectroscopy in patients with seizure disorders

S. N. Breiter, S. Arroyo, V. P. Mathews, R. P. Lesser, R. N. Bryan, P. B. Barker

Research output: Contribution to journalArticlepeer-review

91 Scopus citations


PURPOSE: To evaluate the ability of proton MR spectroscopy to detect metabolic abnormalities in the seizure focus of humans with epilepsy. METHODS: Single-voxel MR spectroscopy and MR imaging was performed in a group of 13 patients with a variety of seizure disorders and in the temporal lobes of 14 healthy volunteers. Signals from choline, creatine, N-acetyl-L- aspartate, and lactate were quantitated in both the epileptogenic focus and the contralateral brain region. RESULTS: In normal temporal lobe, concentrations of choline, creatine, and N-acetyl-L-aspartate were 2.0 ± 0.7, 7.8 ± 1.9, and 11.0 ± 2.1 μmol/g wet weight, respectively, with no detectable lactate. In all patients, a reduction in the N-acetyl-L-aspartate signal was observed in the electrically defined (scalp electroencephalogram) seizure focus compared with the mirror-image contralateral side. Lactate was elevated only in patients who had seizures during or immediately before the MR examination. Seven of 13 patients studied had normal MR examinations. CONCLUSIONS: Proton spectroscopy demonstrates alterations in N-acetyl-L- aspartate and lactate levels that can be used to locate the epileptogenic focus and may be a useful adjunctive diagnostic technique for the evaluation of patients with seizures who are eligible for resective surgery.

Original languageEnglish (US)
Pages (from-to)373-384
Number of pages12
JournalAmerican Journal of Neuroradiology
Issue number2
StatePublished - Jan 1 1994

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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