Release date: 2006-11-03
Before undergoing epilepsy surgery, magnetic resonance spectroscopy (MRS) can play a valuable role in assessing the epileptogenic focus. A meta-analysis conducted by Willmann and colleagues at the University Hospital in Mannheim, Germany, highlights the potential of 1H-MRS in predicting surgical outcomes. The study was published online on August 3, 2006, in *Epilepsy Research*.
A total of 22 studies, published between 1992 and 2003, were included in the analysis. These studies focused on patients with refractory temporal lobe epilepsy, though there was significant variability in the methods used, as well as in how data was interpreted and evaluated.
The findings revealed that 64% of patients showed ipsilateral MRS abnormalities corresponding to the epileptogenic focus, while 72% of those who had good postoperative outcomes also exhibited such findings. The positive predictive value for ipsilateral abnormalities indicating a favorable outcome was 82%. Patients with unilateral MRS abnormalities were more likely to have better outcomes compared to those with bilateral abnormalities, with an odds ratio of 4.891.
Although the researchers acknowledge that MRS is still primarily a research tool, they note its clinical potential. The results suggest that when MRS identifies an ipsilateral abnormality consistent with the epileptogenic zone, it may be associated with improved post-surgical outcomes. However, the predictive accuracy of MRS might vary depending on the patient population. Further prospective studies are needed, especially in cases where MRI or EEG findings are inconclusive.
This information was originally reported in the *China Medical Tribune*.
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