Master of Science
Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy, and one that is generally amenable to surgical treatment when surgery is necessary. Unfortunately, roughly 25-30% of the patient population have no visible lesions on clinical MRI scans. Without anatomical abnormalities to help guide surgical resection, the success of surgical treatment decreases substantially. However, metabolic abnormalities may exist that could allow for accurate localization of epileptic tissue in this cohort. Magnetic resonance spectroscopy (MRS) is a technique that can detect and measure the concentration of metabolically important molecules within tissue, giving insight into the underlying cellular metabolism.
In this thesis, non-lesional TLE patients were studied and compared with control subjects using single voxel MRS at a magnetic field strength of 7T for the first time. We hypothesized that metabolite changes in the hippocampus would be associated with seizure lateralization. Non-lesional patients showed altered levels of creatine and choline when compared to healthy controls. These results were in agreement with prior work in the literature showing non-lesional TLE is primarily a result of glial cell proliferation without neuronal atrophy. However, in the patient cohort studied, these metabolites did not effectively lateralize seizure origin, potentially due to the varied underlying pathologies within the patient group.
Adams, John Robert, "7T Magnetic Resonance Spectroscopy of Non-Lesional Temporal Lobe Epilepsy" (2018). Electronic Thesis and Dissertation Repository. 5760.