Prognostic value of qualitative magnetic resonance imaging hippocampal abnormalities in patients undergoing temporal lobectomy for medically refractory seizures

Epilepsia. May-Jun 1994;35(3):520-4. doi: 10.1111/j.1528-1157.1994.tb02471.x.


In patients with temporal lobe epilepsy (TLE), high-resolution, magnetic resonance imaging (MRI) frequently demonstrates hippocampal atrophy and increased hippocampal signal. To assess the prognostic value of these findings, we studied 51 patients evaluated prospectively by a radiologist blinded to other preoperative evaluations. Thirty-one of 51 (61%) patients undergoing temporal lobectomy had visually apparent hippocampal atrophy or increased hippocampal signal on MRI (25 ipsilateral 3 contralateral, and 3 bilateral to the operated site). Patients with ipsilateral abnormalities became seizure-free more frequently than patients with normal scans [24 of 25 (96%) vs. 10 of 20 (50%) p < 0.015]. Both ipsilateral hippocampal atrophy and ipsilateral increased hippocampal signal independently predicted a seizure-free outcome. Qualitative MRI provides important prognostic information in patients undergoing temporal lobectomy.

MeSH terms

  • Atrophy / pathology
  • Electroencephalography
  • Epilepsy, Temporal Lobe / diagnosis
  • Epilepsy, Temporal Lobe / pathology
  • Epilepsy, Temporal Lobe / surgery*
  • Functional Laterality / physiology
  • Hippocampus / pathology*
  • Humans
  • Magnetic Resonance Imaging*
  • Prognosis
  • Sclerosis / pathology
  • Signal Processing, Computer-Assisted
  • Temporal Lobe / pathology
  • Temporal Lobe / surgery*
  • Treatment Outcome