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Proton Magnetic Resonance Spectroscopic Observations of Epilepsia Partialis Continua in Children

Department of Neurology, Medical College of Georgia, ypark{at}neuro.mcg.edu

Jerry D. Allison, PhD

Department of Radiology, Medical College of Geprgoa

Kenneth L. Weiss, MD

Department of Radiology, Medical College of Geprgoa

Joseph R. Smith, MD

Department of Surgery (Neurosurgery) Medical College of Georgia, Augusta, Georgia

Mark R. Lee, MD, PhD

Department of Surgery (Neurosurgery) Medical College of Georgia, Augusta, Georgia

Don W. King, MD

Department of Neurology, Medical College of Georgia

We performed magnetic resonance spectroscopy in three pediatric patients (two boys and one girl, ages 11 to 17 years) with epilepsia partialis continua. Single-voxel proton magnetic resonance spectroscopy was performed on each patient. Data were acquired from voxels of 4 or 8 cm3 from the affected hemisphere and from contralateral homologous regions. The spectral peaks of several metabolites (N-acetyl-aspartate, choline, creatine, and lactate) were measured. Neuropathologic findings revealed Rasmussen's syndrome in two children and gliosis in one. We observed increased lactate-to-creatine ratios and reduced N-acetyl-aspartate-to-creatine ratios in the affected hemispheres in all three children with epilepsia partialis continua. These data support previous reports. The largest increase in the lactate-to-creatine ratio was detected in a patient with Rasmussen's syndrome and ongoing epilepsia partialis continua at the time of measurement. The other two patients had an increase in the lactate-to-creatine ratio and a decrease in the N-acetyl-aspartate-to-creatine ratio in the affected area. The increased lactate-to-creatine ratio was associated with recurrent focal seizures from different underlying pathologies. (J Child Neurol 2000;15:729-733).

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