3D Proton MR Spectroscopy of Normal-Appearing Brain in Tuberous Sclerosis Complex

Ivan Kirov¹, Sarah Milla¹, Joseph Oved², Orrin Devinsky³, Howard Weiner³, Oded Gonen¹

Refractory epilepsy in Tuberous Sclerosis Complex (TSC) is treated by resection of the seizure locus localized by electro-encephalography. The traditional surgery target is the tuber, which is considered to be intrinsically epileptogenic. A subset of patients, however, experience epilepsy, but are tuber-free on conventional MRI and are often excluded from surgery. We used three-dimensional proton MR spectroscopy (1H-MRS) to examine the normal-appearing tissue in these patients. Our initial results reveal metabolic abnormalities in the tuber-free brain in TSC. 1H-MRS in this subset of patients may be a useful marker for identifying MR-occult pathology.