Proton magnetic resonance spectroscopy characteristics of a focal cortical dysgenesis during status epilepticus and in the interictal state

• Published in: Seizure (London, England) Vol. 10; no. 7; pp. 518 - 524
• Main Authors: Mueller, S.G, Kollias, S.S, Trabesinger, A.H, Buck, A, Boesiger, P, Wieser, H.G
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2001
• Subjects: Adult; Aspartic Acid - metabolism; Brain - abnormalities; Brain - metabolism; cortical dysgenesis; epilepsy; Female; Humans; lactate; Magnetic Resonance Spectroscopy; Protons; Severity of Illness Index; spectroscopy; Status Epilepticus - diagnosis; epilepsy; cortical dysgenesis; lactate; spectroscopy
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1053/seiz.2001.0541

We report the magnetic resonance imaging and proton magnetic resonance spectroscopic findings (1HMRS) in a patient with a focal cortical dysgenesis in the right superior frontal gyrus during intermittent frontal status epilepticus (IFSE) with simple partial seizures, and after she had become seizure free. During the status epilepticus, demonstrated by simultaneous behavioural and electroencephalographic telemetric long-term monitoring with scalp electrodes and ictal SPECT, we performed a single voxel spectroscopy of the dysgenic cortex. The1HMRS was repeated after 20 days when the patient's seizures were controlled. The N-acetyl-aspartate concentration in the focal dysgenic cortex was decreased in the interictal state but more during IFSE. The creatine/phosphocreatine concentration was normal in both instances. There was a clear lactate signal during IFSE, which was no longer visible in the interictal state. To our knowledge this is the first report of a1HMRS study of a focal cortical dysgenesis during an intermittent status epilepticus. We interpret the observed changes as signs of histopathological changes inherent to a cortical malformation and of an impaired energy metabolism due to the partial status epilepticus.