This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To prospectively assess the frequency of mesiotemporal abnormalities seen on brain MRI in healthy subjects in comparison with patients with temporal lobe epilepsy (TLE).
Methods: Ninety-nine consecutive patients (48 women, mean age 36.1 ± 16.1 years; range 10 to 75) with TLE and 51 healthy volunteers (26 women, mean age 39.3 ± 10.8 years) prospectively underwent the same MRI protocol, specific for TLE. Images were reviewed independently by 2 neuroradiologists blinded to clinical information. Cortical atrophy and signal intensities in the amygdala, hippocampus, cingulate gyrus, subcallosal area, insula, temporal parietal, and occipital lobe were graded relative to cortical signal intensity in the frontal lobe. Intrarater and interrater reliability were also assessed.
Results: Interrater and intrarater measurements demonstrated consistent and repeatable results. Forty-seven of 99 (47.5%) patients showed either unilateral or bilateral major T2/fluid-attenuated inversion recovery hyperintensities of the hippocampus, and 19 patients (19.2%) showed hippocampal atrophy seen at T1/inversion recovery sequences. In the controls, 15/51 (29.4%) individuals had unilateral or bilateral hyperintensities, which did not differ from the rate of occurrence in patients (p = 0.08). Conversely, unilateral hippocampal atrophy was found in 1 control, which was significantly different (p = 0.005) from the rate of occurrence in patients. Hyperintensity plus structural hippocampal atrophy were only seen in patients.
Conclusions: On brain MRI, either unilateral or bilateral hippocampal hyperintensities are frequently encountered in healthy volunteers. Conversely, hippocampal atrophy, especially when associated with concomitant hyperintensity, was seen exclusively in the epilepsy group, indicating that the combination of these 2 variables represents the strongest and most reliable indicator of epilepsy.
Glossary
- FLAIR=
- fluid-attenuated inversion recovery;
- HS=
- hippocampal sclerosis;
- IR=
- inversion recovery;
- TLE=
- temporal lobe epilepsy.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
- Temporal lobe abnormalities on brain MRI in healthy volunteers: A prospective case-control study
- Reply from the authors
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
