The Relation Between Brain MRI Lesion Load And Epilepsy Secondary To Tuberous Sclerosis Complex

Purpose: The purpose of this study was to reveal the association between MRI brain lesion load and epileptic characteristics.Methods: The epileptic characteristics were collected through retrospective chart review. Three-dimensional T1 and FLAIR MRI data were obtained and brain lesions were segmented with automatic algorithms of medical image processing softwares. The conceptions total lesion/brain proportion (TLBP), the proportion of total brain volume occupied by lesions, and Cortical lesion/cortex proportion (CLCP), the proportion of cortical volume occupied by lesions, were proposed as measurements of MRI lesion load. Afterward, the epileptic characteristics and MRI lesion load were statistically described and the association between them were tested.Results: 24 patients were included. Both FLAIR-TLBP and FLAIR-CLCP were found inversely related to age at seizure onset, which was also influenced by perinatal asphyxia. Both FLAIR-TLBP and FLAIR-CLCP were significantly higher in patients with a history of infantile spasms than in those without. Epileptic spasms was distinguished from other seizure types originated from infantile spasms, when comparing the mean FLAIR-CLCP of the patients with continuous spasms after infancy with that of the patients with transformed seizure types. In patients without a history of infantile spasms, no difference of lesion load were found between groups with different dominant seizure phenotypes. T1 lesion load were related to neither age at seizure onset nor seizure types.Conclusion: There was significant relation between FLAIR, especially cortical, lesion load and epileptic characteristics (age at seizure onset and the seizure types). The association between T1 lesion load and epileptic characteristics still need to be further studied.