Brain MRI of hippocampal volumetry in patients with refractory temporal lobe epilepsy.

OBJECTIVE

To detect for hippocampal sclerosis presurgically in a group of patients with refractory temporal lobe epilepsy.

METHODS

Eighty-four consecutive patients with refractory temporal lobe epilepsy were subjected to brain MRI of hippocampal volumetry. A ratio of smaller to larger hippocampal volume was determined and unilateral hippocampal atrophy (HA) was diagnosed if the ratio is less than 0.91.

RESULTS

Unilateral HA was diagnosed in 42 patients (50%) and bilateral HA in 1 patient. Other MRI abnormalities were detected in 18 patients with or without coexisting HA.

CONCLUSIONS

Hippocampal sclerosis can be detected presurgically in many patients by brain MRI. Additional abnormalities not detected by brain CT can also be demonstrated.