Objective To investigate the application of proton magnetic resonance spectroscopy (1H-MRS) combined with magenetic resonance imaging (MRI) in detecting biochemical metabolism in children with epilepsy. Methods In 20 cases of epilepsy,6 were intractable epilepsy and 8 normal subjects exprienced MRI and single-voxel 1H-MRS exminations by locating in the amygdaloid-hippocampus The signal intensities of N-acetylaspartate(NAA),creatine+phosphocreatine(Cr),choline-containig compounds(Cho) and the ratios of NAA/Cho+cr,NAA/Cho,and NAA/Cr were set into comparison bilaterally between the patients and controls. Results 15 patients were abnormal in 1H-MRS examination The signal intensity of NAA in MRI abnormal area was obviously lower than that in the contralaterals of focus and the controls,the Cho was higher than in the contralaterals and controls;NAA/Cho+Cr (0 59?0 11) and NAA/Cho (1 08?0 36) were lower than those in contralaterals (0 75?0 17,1 40?0 38)and controls (0 77?0 12,1 29?0 48) NAA,Cho,Cr and ratios of NAA/Cho+Cr,NAA/Cho,NAA/Cr of the left and the right side of controls were not significantly different There are decreases of bilateral NAA and ratio NAA/Cho+Cr in 5 out of the 6 children with intractable epilepsy. Conclusions Signal intensity of NAA and ratio NAA/Cho+Cr,NAA/Cho in children with epilepsy were decreased by 1H-MRS detection These spectral abnormalities may reflect neuronal loss or dysfunction,there are bilateral diffuse abnormalities in the intractable epilepsy 1H-MRS may help understand the underlying pathophysiology in children with epilepsy