Epilepsy is a chronic neurological disorder that affects approximately 1% of the world's population. Mesial temporal lobe epilepsy (MTLE) is the most common type of epilepsy, and is associated with hippocampal sclerosis. The seizure cannot be controlled by medication in 30% of patients. The surgical treatment is one of the treatment for these patients. Published data estimate that among MTLE patients who have undergone surgical resection, 70-90% of them have enjoyed seizure-free outcomes. Poor surgical outcomes have been observed in MTLE patients who were thought to have unilateral disease but who were shown to have evidence of bilateral hippocampal and extra temporal pathology.
Dr. Salamon proposes whether we can detect the contralateral hippocampal disease or extra hippocampal pathology using a new MRI technique: diffusion tensor imaging (DTI). DTI can detect subtle changes in the brain which is not seen with conventional MRI. DTI can be used in many neuropsychiatric disorders or neurodegenerative disease. With DTI, the patient of MTLE will be evaluated not only to define the pattern of structural change but also the progression of the extra temporal damage to understand the progression of the disease. This will help preoperatively to predict the post surgical outcome of MTLE patients.In the awarded proposal, Dr. Noriko Salamon proposes to use Diffusion Tensor Imaging technique to detect the contralateral hippocampal disease or extra hippocampal pathology.