Focal cerebral lesions found by magnetic resonance imaging in cryptogenic nonrefractory temporal lobe epilepsy patients

Brain magnetic resonance imaging (MRI) was studied in patients with mild-to-moderate temporal lobe epilepsy (TLE), well controlled by pharmacotherapy, and with normal computed tomographic (CT) scans. Magnetic resonance imaging abnormalities were found in 19 patients; of these, nine had abnormalities in temporomesial regions and four in temporobasal regions. Six patients had white matter MRI lesions of nonspecific significance. The temporomesial MRI lesions were compatible with sclerosis of Ammonis cornu. Patients with this MRI finding had more severe and longer lasting TLE than those without MRI abnormalities. The temporobasal lesions were interpreted as potentially developing brain lesions. Correlation between EEG and MRI findings was good. We conclude that MRI is more useful than CT for diagnosis of patients with mild-to-moderate TLE.