Evaluation of Brain Metabolites Alteration in Mri-Negative Epilepsy by Magnetic Resonance Spectroscopy

Refractory epilepsy patients with no clear sign in MRI images who called MRI-negative are a challenging group undergoing pre-surgical and treatment evaluations. Finding epilepsy focus in refractory epilepsy patients without any lesions has been noticed recently. To investigate pathology of epileptogenic zone, magnetic resonance spectroscopy has been introduced. Alteration brain metabolites could reveal neuronal and tissue changes in epileptogenic regions. In order to achieve the goal, MRI scans has been performed on ۱۵ epilepsy patients (average age-۲۵yrs). MRS protocols has been administrated and differences of metabolites has been measured in Video-EEG recognized zone by drawing many Region of interest in certain regions of involved epilepsy and normal hemispheres. Our results have been showed the significant alterations has been observed in myo-inositol metabolite between two hemispheres. Significant differences in other metabolites have not been observed despite metabolites value alterations. The measurements could reveal significant increase in myo-inositol which a marker of glial cells activation. High activation of Glial cells as immune cells of brain could show presence of factors like inflammation in epileptogenic zone. MRS and myo-inositol marker could be an appropriate way to find pathologies of suspicious region of seizure in other types of epilepsy without lesions and the results would be more powerful by use other adjacent MRI methods with Magnetic resonance spectroscopy.