Magnetic Resonance Imaging in Intractable Temporal Lobe Epilepsy of Childhood Onset.

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Magnetic resonance imaging (MRI) study was performed in 20 patients with intractable temporal lobe epilepsy. Twelve patients showed abnormalities consisting of an increased T2-weighted singal confined to a unilateral small hippocampus. These findings are compatible with mesial temporal sclerosis. Axial Ti-, T2-weighted and coronal T2-weighted images were indispensable to identify mesial temporal sclerosis. A high T2-weighted signal was observed on the right hippocampus of normal size in four patients. Three patients had MRI abnormalities considered to be foreign tissue lesions. Only one had no MRI abnormalities. These results indicate that MRI is a sensitive technique for detecting mesial temporal sclerosis, foreign tissue lesions and other lesions in patients with intractable temporal lobe epilepsy.<BR>The history of prolonged childhood convulsions (more than 30 minutes) was observed only in the patients with MRI abnormalities suggesting mesial temporal sclerosis. These results suggest that mesial temporal sclerosis may be a cause of the temporal lobe epilepsy rather than a result of repeated epileptic seizures.
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