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Ruben Kuzniecky, MD; Sheila Burgard, MS; Edward Faught, MD; Richard Morawetz, MD; Alfred Bartolucci, PhD

Arch Neurol. 1993;50(1):65-69.

Abstract
• The predictive value of magnetic resonance imaging (MRI) was assessed by a prospective study of 34 patients selected for surgical treatment of temporal lobe epilepsy. The MRIs were interpreted using standardized visual diagnostic criteria and the imaging findings were correlated with the surgical outcome. Lateralized MRI abnormalities were found in 25 (74%) of 34 patients. Significant associations were found between either the presence of a restricted foreign-tissue lesion or hippocampal atrophy and an excellent surgical outcome. An abnormal MRI had an 82% predictive value and a normal MRI had a 56% predictive value for surgical success. A history of febrile convulsions and the presence of hippocampal atrophy best predicted outcome (predictive value, 86%). These results suggest that specific MRI findings in candidates for temporal lobe epilepsy surgery are predictive of surgical outcome. The information provided by MRI may be of value for counseling patients prior to surgical intervention.

Author Affiliations
From the University of Alabama at Birmingham Epilepsy Center, Departments of Neurology (Drs Kuzniecky and Faught), Neurosurgery (Dr Morawetz), and Biostatistics and Biomathematics (Ms Burgard and Dr Bartolucci), University of Alabama at Birmingham.

Footnotes
Accepted for publication June 10, 1992.

Reprint requests to the University of Alabama at Birmingham Epilepsy Center, Department of Neurology, UAB Station, Birmingham, AL 35294 (Dr Kuzniecky).

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