Frontal Lobe Epilepsy Associated With Tuberous Sclerosis: Electroencephalographic-Magnetic Resonance Image Fusioning

Abstract BACKGROUND: Epilepsy surgery for magnetic resonance imaging (MRI)-negative patients has a less favorable outcome. OBJECTIVE: Detection of subclinical abnormal gyration (SAG) patterns and their potential contribution to assessment of the topography of the epileptogenic zone (EZ) is addressed in MRI-negative patients with frontal lobe epilepsy. METHODS: Between September 1998 and July 2005, 12 MRI-negative frontal lobe epilepsy patients underwent stereoelectroencephalography with postcorticectomy follow-up of longer than 1 year (average, 3.3 years). Original software (BrainVISA/Anatomist, http://brainvisa.info) trained on a database of normal volunteers was used to determine which sulci had morphology out of the normal range (SAG). Topography of the EZ, SAG pattern, corticectomy, postoperative seizure control, and histopathology were analyzed. RESULTS: At last follow-up, 8 of 12 patients (66.7%) were Engel class I (7 IA and 1 IB), 2 class II, and 2 class IV. Small focal cortical dysplasia was histologically diagnosed in 9 of the 12 patients (75%), including 7 of 8 seizure-free patients (87.5%). A SAG pattern was found to be in the EZ area in 9 patients (75%), in the ipsilateral frontal lobe out of the EZ in 2, and limited to the contralateral hemisphere in 1. CONCLUSION: SAG patterns appear to be associated with the topography of the EZ in MRI-negative frontal lobe epilepsy and may have a useful role in preoperative assessment. Small focal cortical dysplasia not detected with MRI is often found on histopathological examination, particularly in the depth of the posterior part of the superior frontal sulcus and intermediate frontal sulcus, suggesting a specific developmental critical zone in these locations.

Download Full-text

Phosphorus magnetic resonance spectroscopic imaging in patients with frontal lobe epilepsy

Annals of Neurology ◽

10.1002/ana.410350214 ◽

1994 ◽

Vol 35 (2) ◽

pp. 217-221 ◽

Cited By ~ 32

Author(s):

Paul A. Garcia ◽

Kenneth D. Laxer ◽

Jeroen van der Grond ◽

James W. Hugg ◽

Gerald B. Matson ◽

...

Keyword(s):

Magnetic Resonance ◽

Frontal Lobe ◽

Spectroscopic Imaging ◽

Magnetic Resonance Spectroscopic Imaging ◽

Frontal Lobe Epilepsy

Download Full-text

PS-58-8 1H-magnetic resonance spectroscopy in a patient with seizures of the supplementary motor area in frontal lobe epilepsy

Electroencephalography and Clinical Neurophysiology/Electromyography and Motor Control ◽

10.1016/0924-980x(95)93338-t ◽

1995 ◽

Vol 97 (4) ◽

pp. S240

Author(s):

T. Okuno ◽

T. Imai ◽

M. Matsuo

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Frontal Lobe ◽

Supplementary Motor Area ◽

Motor Area ◽

Resonance Spectroscopy ◽

Frontal Lobe Epilepsy ◽

1H Magnetic Resonance Spectroscopy

Download Full-text

Event-related desynchronization of cortical rhythms during a voluntary movement in frontal lobe epilepsy

Electroencephalography and Clinical Neurophysiology ◽

10.1016/s0013-4694(97)88717-6 ◽

1997 ◽

Vol 103 (1) ◽

pp. 155

Author(s):

P Derambure

Keyword(s):

Frontal Lobe ◽

Voluntary Movement ◽

Frontal Lobe Epilepsy ◽

Event Related Desynchronization ◽

Cortical Rhythms

Download Full-text

Magnetic resonance image attributes of the bovine ovarian follicle antrum during development and regression

Reproduction ◽

10.1530/reprod/120.2.311 ◽

2000 ◽

pp. 311-323 ◽

Cited By ~ 3

Author(s):

JL Hilton ◽

GE Sarty ◽

GP Adams ◽

RA Pierson

Keyword(s):

Magnetic Resonance ◽

Relaxation Rate ◽

Follicular Fluid ◽

Magnetic Resonance Image ◽

Follicular Development ◽

Physiological Status ◽

Proton Density ◽

Dominant Follicle ◽

Rate Heterogeneity ◽

Pixel Value

The magnetic resonance images and maps of bovine ovaries acquired at defined phases of follicular development and regression were studied to determine whether magnetic resonance image attributes of the follicular antrum reflect the physiological status of dominant and subordinate ovarian follicles. Ovariectomies were performed at day 3 of wave one, day 6 of wave one, day 1 of wave two and at >/= day 17 after ovulation. The timings of ovariectomies were selected to acquire growing, early static, late static and regressing follicles of the first wave and preovulatory follicles of the ovulatory wave. Pre-selection and subordinate follicles were also available for analysis. Serum samples were taken on the day of ovariectomy and follicular fluid samples were taken after imaging. Numerical pixel value and pixel heterogeneity in a spot representing approximately 95% of the follicular antrum were quantified in T(1)- and T(2)-weighted images. T(1) and T(2) relaxation rates (T(1) and T(2)), proton density, apparent diffusion coefficients and their heterogeneities were determined from the computed magnetic resonance maps. The antra of early atretic dominant follicles showed higher T(2)-weighted mean pixel value (P < 0.008) and heterogeneity (P < 0. 01) and lower T(2) heterogeneity (P < 0.008) than growing follicles. Subordinate follicles in the presence of a preovulatory dominant follicle had higher T(1), T(1) heterogeneity, proton density, proton density heterogeneity, and lower mean pixel value in T(1)-weighted images than subordinate follicles of the anovulatory wave (P < 0.04). T(1) relaxation rate heterogeneity and proton density heterogeneity were positively correlated with follicular fluid oestradiol concentration (r = 0.4 and 0.3; P < 0.04). T(2) relaxation rate heterogeneity was positively correlated with follicular fluid progesterone concentration (r = 0.4; P < 0.008). Quantitative differences in magnetic resonance image attributes of the antrum observed among phases of follicular development and regression coincided with changes in the ability of the dominant follicle to produce steroid hormones and ovulate, and thus were indicative of physiological status and follicular health.

Download Full-text