Diffusion Tensor Imaging In Refractory Partial Epilepsy

[Objective] Patients with refractory partial epilepsy may benefit from epilepsy surgery. Identification of a structural lesion is fundamental to pre-surgical evaluation. The aim of this study is to test the hypothesis that DTI would identify focal abnormality in patients with refractory partial epilepsy and normal conventional MRI.[Methods]Thirty healthy volunteers with no history of neurological disease and 12 patients with refractory partial epilepsy were scanned with conventional MRI and DTI at GE EXITE 3.0T MR scanning system. Individual maps of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated and normalized to a standard template. The patients were compared individually with the 30 control subjects on a voxel-by-voxel basis using statistical parametric mapping (SPM2). Significant differences in diffusivity or anisotropy were detected at a threshold of P<0.001 (corrected for multiple comparisons with P< 0.05).[Result] Individual analysis of the 12 patients with partial seizures and normal optimal MRI identified diffusion abnormalities in all patients. Ten of them, whose suspected onset of seizures were temporal in 3 patients, frontal in 5 and occipital in 2, concurred with the eletroclinical seizure localization. A significant increase in ADC (P < 0.001) was found in all patients and ten of which was located in the regions concurred with the localization of...