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Hippocampal and thalamic diffusion abnormalities in children with temporal lobe epilepsy
Tomomi Kimiwada1, Csaba Juhász, Malek Makki
1Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Epilepsia
|January 19, 2006
Summary
Diffusion tensor imaging (DTI) reveals hippocampal abnormalities in children with partial epilepsy, aiding in seizure focus lateralization. Contralateral hippocampal dysfunction suggests broader network involvement, even with unilateral onset.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Pediatric Neurology
Background:
- Temporal lobe epilepsy (TLE) is often associated with hippocampal abnormalities.
- The thalamus and lentiform nuclei play roles in regulating cortical excitability and seizure propagation.
- Understanding subcortical involvement in pediatric epilepsy is crucial for treatment.
Purpose of the Study:
- To investigate diffusion tensor imaging (DTI) abnormalities in the hippocampus, thalamus, and lentiform nuclei of children with partial epilepsy.
- To compare DTI findings between children with and without secondary generalization.
- To correlate DTI findings with glucose positron emission tomography (PET) data.
Main Methods:
- MRI including DTI sequences in 14 children with partial epilepsy.
- Acquisition of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values.
- Comparison with 14 age-matched healthy controls and analysis of PET findings.
Main Results:
- Decreased FA and increased ADC in hippocampi ipsilateral to the seizure focus (p < 0.001).
- Significant FA decrease in contralateral hippocampi (p = 0.002), indicating bilateral dysfunction.
- Trend for increased ADC in thalami of children with secondarily generalized seizures (p = 0.09).
Conclusions:
- Increased hippocampal ADC aids in seizure focus lateralization.
- Decreased contralateral hippocampal FA suggests dysfunction despite unilateral onset.
- DTI is sensitive for detecting abnormalities in pediatric epilepsy, even in structures not apparent on conventional MRI.