Ivan Kirov1, Sarah Milla1,
Joseph Oved2, Orrin Devinsky3, Howard Weiner3,
Oded Gonen1
1Radiology, New York
University, New York, NY, United States; 2School of Medicine, New
York University, New York, United States; 3Neurosurgery, New York
University, New York, NY, United States
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.