Objective:To further investigate the ability of MRI and ~1H-MRS techniques for presurgical evaluation of hippocampal sclerosis. Methods:MRI and ~1H-MRS were performed on 30 healthy subjects to determine the confidence levels.Eight patients who were pathologically confirmed hippocampal sclerosis were then studied using the same protocols.The difference of hippocampal formation (DHF) was used to determine atrophy of hippocampus.Areas under the peak of N-acetylaspartate(NAA),Creatine(Cr) and Choline (Cho) were measured,and the ratios of NAA/Cr,Cho/Cr,and NAA/Cr+Cho were calculated.NAA/Cr+Cho value was applied to localize the seizure focus.Results:Two patients showed hippocampal atrophy according to DHF value.NAA/Cr ratio decreased significantly in ipsilateral hippocampus compared to that in contralateral hippocampus and control subjects(P<0.01).Cho/Cr value increased in both ipsi- and contralateral hippocampus in comparison with that in control subjects(P<0.01).NAA/Cr+Cho ratio,however. significantly reduced in both ipsi-and contralateral hippocampus(P<0.01) with lowest NAA/Cr+Cho ratio in seizure loci.Six patients could be lateralized by reduced and/or asymmetric NAA/Cr+Cho value.Conclusion:~1H-MRS should be a promising diagnostic tool to detect neuron abnormality.~1H-MRS and MRI complement each other in presurgical lateralization of epileptogenic lesion in epilepsy patients. Objective: To further investigate the ability of MRI and ~ 1H-MRS techniques for presurgical evaluation of hippocampal sclerosis. Methods: MRI and ~ 1H-MRS were performed on 30 healthy subjects to determine the confidence levels. Light patients who had acquired identically hippocampal sclerosis were then studied using the same protocols.The difference of hippocampal formation (DHF) was used to determine atrophy of hippocampus. Are under the peak of N-acetylaspartate (NAA), Creatine (Cr) and Choline (Cho) were measured, and the NAA / Cr + Cho were was applied to localize the seizure focus. Results: Two patients showed hippocampal atrophy according to DHF value. NAA / Cr ratio was applied to localize the seizure focus. Results: NAA / Cr, Cho / significantly in ipsilateral hippocampus compared to that in contralateral hippocampus and control subjects (P <0.01) .Cho / Cr value increased in both ipsi- and contralateral hippocampus in comparison with that in control subjects (P <0.01) .NAA / Cr + Cho ratio However, s ignificantly reduced in both ipsi-and contralateral hippocampus (P <0.01) with lowest NAA / Cr + Cho ratio in seizure loci.Six patients could be lateralized by reduced and / or asymmetric NAA / Cr + Cho value. Conlusion: ~ 1H- MRS 1H-MRS and MRI complement each other in presurgical lateralization of epileptogenic lesion in epilepsy patients.