Jullie W. Pan1, Dennis D. Spencer1, R. Bradley Duckrow2, Nikolai Avdievich1, Hoby P. Hetherington1
1Neurosurgery, Yale University School of Medicine, New Haven, CT, USA; 2Neurology, Yale University School of Medicine, New Haven, CT, USA
The presence of unilateral hippocampal atrophy in the evaluation of medial temporal lobe epilepsy (MTLE) is often a defining factor that if concordant with the EEG and PET and not contraindicated from neuropsychological data, will typically result in candidacy for surgical resection. However, it is possible to have hippocampal atrophy (HA) without intractable seizures particularly in familial MTLE. We used ultra-high field MR spectroscopic imaging at 7T to assess MTLE with patients who are all HA positive. We studied n=12 patients who were medically intractable and n=2 patients who were very well controlled (seizure free for >2years on medication).