Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM

Background: Hippocampal formation analysis by magnetic resonance imaging (MRI) and proton MR spectroscopy (1H-MRS) is useful for lateralization of seizure focus and diagnosis of medical intractable temporal lobe epilepsy (MTLE). The present study assessed the diagnostic utility of MRS, MRI, and c...

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Main Author:	Dharmalingam, Gyathri Devi A/P
Format:	Thesis
Language:	English
Published:	2017
Subjects:	RC31-1245 Internal medicine
Online Access:	http://eprints.usm.my/44623/1/Dr.%20Gyathri%20Devi%20AP%20Dharmalingam-24%20pages.pdf
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spelling	my-usm-ep.446232020-10-22T03:03:11Z Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM 2017-05 Dharmalingam, Gyathri Devi A/P RC31-1245 Internal medicine Background: Hippocampal formation analysis by magnetic resonance imaging (MRI) and proton MR spectroscopy (1H-MRS) is useful for lateralization of seizure focus and diagnosis of medical intractable temporal lobe epilepsy (MTLE). The present study assessed the diagnostic utility of MRS, MRI, and combinatorial MRI-MRS findings from hippocampal formation of MTLE patients. Methods: A total of 14 MTLE patients and 14 control subjects were underwent MRI and MRS examination on hippocampal formation. The patients were clinically diagnosed as MTLE patients and revealed unilataralization by electroencephalogram (EEG) examination. The patient was ensured seizure free for a minimum period of 24 hours before the analyses to avoid possible effect of acute post ictal changes. Results: There were significant (p<0.05) decrement in NAA/Cr and increment in Cho/Cr in ipsilateral hippocampal formation of MTLE patients compared to that of contralateral findings and control group, separately. In the evaluation of diagnostic utility of individual MRS value for detection of epileptic focus in hippocampal formation, only NAA/Cr and NAA/Cho revealed significant moderate and fair agreements with the EEG lateralization findings, respectively. Analysis by combinatorial MRS values or MRI alone revealed fair and moderate agreement with EEG lateralization findings, respectively. Analysis using combinatorial MRS+MRI showed substantial agreement with with EEG lateralization findings. The positive andnegative percentage agreements with EEG lateralization findings were 79% and 93%, respectively. Conclusion: Combinatorial MRS+MRI analysis improved the lateralization of epileptic focus and diagnosis of MTLE. 2017-05 Thesis http://eprints.usm.my/44623/ http://eprints.usm.my/44623/1/Dr.%20Gyathri%20Devi%20AP%20Dharmalingam-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC31-1245 Internal medicine
spellingShingle	RC31-1245 Internal medicine Dharmalingam, Gyathri Devi A/P Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
description	Background: Hippocampal formation analysis by magnetic resonance imaging (MRI) and proton MR spectroscopy (1H-MRS) is useful for lateralization of seizure focus and diagnosis of medical intractable temporal lobe epilepsy (MTLE). The present study assessed the diagnostic utility of MRS, MRI, and combinatorial MRI-MRS findings from hippocampal formation of MTLE patients. Methods: A total of 14 MTLE patients and 14 control subjects were underwent MRI and MRS examination on hippocampal formation. The patients were clinically diagnosed as MTLE patients and revealed unilataralization by electroencephalogram (EEG) examination. The patient was ensured seizure free for a minimum period of 24 hours before the analyses to avoid possible effect of acute post ictal changes. Results: There were significant (p<0.05) decrement in NAA/Cr and increment in Cho/Cr in ipsilateral hippocampal formation of MTLE patients compared to that of contralateral findings and control group, separately. In the evaluation of diagnostic utility of individual MRS value for detection of epileptic focus in hippocampal formation, only NAA/Cr and NAA/Cho revealed significant moderate and fair agreements with the EEG lateralization findings, respectively. Analysis by combinatorial MRS values or MRI alone revealed fair and moderate agreement with EEG lateralization findings, respectively. Analysis using combinatorial MRS+MRI showed substantial agreement with with EEG lateralization findings. The positive andnegative percentage agreements with EEG lateralization findings were 79% and 93%, respectively. Conclusion: Combinatorial MRS+MRI analysis improved the lateralization of epileptic focus and diagnosis of MTLE.
format	Thesis
qualification_level	Master's degree
author	Dharmalingam, Gyathri Devi A/P
author_facet	Dharmalingam, Gyathri Devi A/P
author_sort	Dharmalingam, Gyathri Devi A/P
title	Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
title_short	Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
title_full	Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
title_fullStr	Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
title_full_unstemmed	Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM
title_sort	diagnostic utility of mrs values in hippocampus formation of medically intractable temporal lobe epilepsy patients in husm
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2017
url	http://eprints.usm.my/44623/1/Dr.%20Gyathri%20Devi%20AP%20Dharmalingam-24%20pages.pdf
_version_	1747821388034473984

Diagnostic utility of MRS values in hippocampus formation of medically intractable temporal lobe epilepsy patients in HUSM

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