Ivan Kirov1, Joseph Oved2, Sarah Milla1, Orrin Devinsky3, Howard Weiner3, Oded Gonen1
1Radiology, New York University, New York, NY, United States; 2School of Medicine, New York University, New York, NY, United States; 3Neurosurgery, New York University, New York, NY, United States
While traditionally the MRI-defined tuber has been the primary surgery target for abolishing seizures in Tuberous Sclerosis Complex (TSC), there is evidence that non-tuberous tissue, specifically surrounding the active tuber, may also be epileptogenic. We use 3D proton MR spectroscopy (1H-MRS) to characterize tubers and normal-appearing tissue. Initial results reveal metabolic abnormalities in tubers and its adjacent tissue (peritubers). In one case electro-encephalography identified a seizure locus and 1H-MRS showed high lipid signal in its perituberous tissue. In all, these findings have implications for improved identification and definition of the epileptogenic zone in TSC.