Temporal lobe epilepsy (TLE) is the most common cause of complex partial seizures. Surgical treatment is an effective therapeutic option for patients who have drug refractory epilepsy. In this study, we sought to examine hippocampus pathologies by using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) in TLE patients.

Thirty-six patients with clinically known TLE and the control group of twelve patients with history of headache were enrolled in this study. All patients underwent MRI nad MRS after investigation of clinical history and lateralization of focus side with EEG. For examination of hippocampus MRS with TE of 135 and 35 ms was performed in addition to the routine cranial MRI protocol. Hippocampal atrophy, hippocampal and parahippocampal signal alterations, temporal horn asymmetry, and spoiling of gray-white matter discriminations were evaluated by MRI. Levels of NAA, mI and ratios of NAA/Cho+Cr, NAA/Cho, NAA/Cr, Cho/Cr, and NAA/mI were measured by MRS.

With TE 135 ms NAA/Cho, and NAA/Cre ratios; and TE 35 ms NAA levels, and NAA/Cho+Cre, NAA/Cr ratios were significantly different between patient and control groups and were lower in TLE patients.

When MRS is compared with MRI, MRS can reveal the pathological changes in an early stage and it is important for the lateralization of the focus side.