Jullie W. Pan1,
R Bradley Duckrow1, Jason Gerrard2, Caroline Ong1,
Lawrence Hirsch3, Stanley Resor, Jr4, Ognen Petroff3,
Susan S. Spencer3, Hoby P. Hetherington5, Dennis D.
Spencer2
1Yale
University School of Medicine, New Haven, CT, United States; 2Neurosurgery,
Yale University School of Medicine, New Haven, CT, United States; 3Neurology,
Yale University School of Medicine, New Haven, CT, United States; 4Neurology,
Columbia University School of Medicine, New York, NY, United States; 5Neurosurgery,
Yale University, New Haven, CT, United States
The challenge in the surgical management of intractable epilepsy remains accurate localization. While the anatomically restricted location in medial temporal lobe epilepsy makes it a relatively well defined target, in neocortical epilepsy, accurate localization remains difficult. We have implemented 7T MR moderate echo TR/TE 1.5s/40ms spectroscopic imaging to study n=25 intractable epilepsy patients. The concordance between MRSI-identified metabolic abnormality and surgical resection was compared with patient outcome as defined by ILAE classes I-III (good) and IV-VI (poor). In n=25 patients we found a significant (p<0.001) relationship between outcome with concordance between NA/Cr abnormalities and surgical resection