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Proceedings of the Association of British Neurologists and the Liaison Psychiatry Group, Royal College of Psychiatrists. April 2-3, 1992. Abstracts.

Hippocampal sclerosis, manifest as volume loss on volumetric MRI studies, correlates strongly with post-surgical outcome in temporal lobe epilepsy surgery. Volumetric MRI techniques were applied to normal subjects (n = 20) and 2 groups of patients, defined on clinical and EEG grounds; temporal lobe (n = 36), and extratemporal (n = 24), to establish whether distinction could be made by hippocampal formation (HF) volume measurements. Imaging was performed on a 1-5T GE Signa, and coronal 1-5 mm contiguous slices of the whole brain acquired using a spoiled gradient echo technique. These were processed on a GE IC, and HF surface area in each slice calculated. Volumes were derived using the Cavilieri principle. These were expressed as total volumes, ratios (smaller/larger), and the cross-sectional area plotted against slice number, allowing assessment of regional involvement. HF volume ratio in normal subjects was always >0-96. Normal HF volumes (volume ratio > 0-96) were found in all extratemporal cases, and in all temporal neocortical lesions. Thirty five of the temporal group had volume ratios of <0 95 (range 0 56-094). Volumetric MRI studies of the HF may help to distinguish between these important clinical groups.