Quantitative Extrahippocampal Abnormality in Patients with Epilepsy

The vast majority of quantitative MR studies using T2 relaxometry are focused on the hippocampus in patients with pathologically proven HS. Changes in other areas have also been documented. Amygdaloid changes were assessed in a study of 29 patients with newly diagnosed and 54 patients with chronic temporal lobe epilepsy. In the newly diagnosed patients, the mean amygdaloid volume did not differ from that in controls. The mean T2 relaxation time in newly diagnosed or chronic patients did not differ from each other or from control values. However, unilateral T2 time of the amygdala was prolonged in 12% (171). T2-weighted signal abnormalities have also been observed in the anterior temporal lobe of TLE patients (252, 330), although their etiology and relevance is not known. We have recently observed T2 relaxometry changes outside the ipsilateral hippocampus of patients with HS, affecting the subcortical structures. These observations suggest that the structural signal abnormality in HS is not restricted to the seizure focus but may affect other areas such as the amygdala and the anterior temporal lobe, contralateral hippocampus, or even more distant areas such as subcortical structures. All these areas may be involved in the spread of the seizure activity.

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