Release date: 2006-11-03
Magnetic resonance spectroscopy (MRS) has shown promise in pre-surgical evaluation for epilepsy, according to a meta-analysis conducted by Willmann and colleagues at the University Hospital in Mannheim, Germany. The study, published online on August 3, 2006, in *Epilepsy Research*, suggests that 1H-MRS can be a valuable tool in identifying epileptogenic foci before surgery, helping clinicians make more informed decisions.
The analysis included 22 studies from 1992 to 2003, all focusing on patients with refractory temporal lobe epilepsy. Despite the consistency in the patient population, there was significant variation in research methods, data interpretation, and technical approaches across the studies. This heterogeneity highlights the need for standardized protocols in future MRS applications.
The findings revealed that 64% of patients showed ipsilateral MRS abnormalities corresponding to the epileptogenic focus, while 72% of those who had favorable postoperative outcomes also exhibited similar findings. The positive predictive value of MRS for a good outcome was 82% when ipsilateral abnormalities were present. Moreover, patients with unilateral MRS abnormalities had a significantly higher likelihood of remaining seizure-free after surgery compared to those with bilateral abnormalities, with an odds ratio of 4.891.
While the researchers acknowledge that MRS remains primarily a research tool, they note its potential clinical value. The study suggests that MRS may serve as a useful predictor of surgical success when it identifies an abnormality consistent with the epileptogenic region. However, further prospective studies are needed, especially in patients whose MRI or EEG results are inconclusive.
— Information from: China Medical Tribune
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