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Clinical Applications and Contributions to the Understanding of Temporal Lobe Epilepsy

Craig Watson, MD, PhD; Clifford R. Jack, Jr, MD; Fernando Cendes, MD, PhD

Arch Neurol. 1997;54(12):1521-1531.

Abstract
In recent years, magnetic resonance imaging—based volumetric measurements of the amygdala and hippocampus have proved useful in the diagnosis and treatment of patients with temporal lobe epilepsy. This imaging modality allows amygdaloid and hippocampal volumes to be correlated with neurophysiological, neuropathological, and neuropsychological findings, surgical outcome, and clinical findings. We evaluated the technical and anatomical aspects underlying the successful use of the modality that were reported in previous studies. We also evaluated issues such as the sensitivity and specificity of volumetric magnetic resonance imaging, its use in bilateral temporal lobe epilepsy, and the debate concerning the sensitivity of qualitative visual analysis vs quantitative volumetric analysis of magnetic resonance images. Volumetric magnetic resonance imaging, when used in conjunction with video electroencephalographic monitoring, neuropsychological studies, and other neuroimaging studies, will enable patients with temporal lobe epilepsy to be treated in an appropriate, efficient, and cost-effective manner.

Author Affiliations
From the WSU/DMC Comprehensive Epilepsy Program, Department of Neurology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Mich (Dr Watson); Department of Diagnostic Radiology, Mayo Clinic, Rochester, Minn (Dr Jack); and Departments of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University School of Medicine, Montreal, Quebec (Dr Cendes).

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