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April2013 Vol.50 Issue:        2        Table of Contents
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Role of Diffusion Tensor Imaging in Mesial Temporal Lobe Epilepsy

Heba I. Ali1, Yasser A. Abbas1, Mona Noureldin2, Hany M. Zakieldine3, Ahmed A. Gaber3

Departments of Radiology; Ain Shams University1, Egypt; John Hopkins School of Medicine2, USA;

Neurology3, Ain Shams University; Egypt


Background: Imaging of epileptics frequently appears normal on conventional magnetic resonance imaging (MRI) even after performing special MR epilepsy protocol. Modern MR Techniques are helpful in assessment of patient with seizures. Objective: This study is aiming to assess the role of diffusion tensor imaging (DTI) in patients with medial temporal lobe epilepsy (MTLE). Methods: Ten patients with MTLE and 10 healthy subjects had performed conventional MRI epilepsy protocol, followed by DTI. MR tractography was then performed for fornix, cingulum and other white matter tracts. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured and then compared quantitatively as an assessment of pertinent regions. All data was correlated with the clinical and advanced EEG of the patient. Results: The patients group, however, had significantly decreased FA values and increased ADC values in the hippocampus as well as the basal ganglia ipsilateral to the seizure focus, and there were mild similar changes in the cingulum, inferior longitudinal fasciculus (ILF) and to a lesser extent in other tracts ipsilateral to seizure focus as suggested by the clinical and EEG findings. Conclusion:  DTI proved to be helpful in the evaluation of patients with MTLE. This is mainly achieved through quantitative assessment of hippocampus. It showed associated deep nuclei and white matter tracts affection in patients with MTLE explaining their clinical and EEG abnormal findings. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(2): 171-176]

 Key Words: Diffusion Tensor Imaging, Mesial Temporal Lobe Epilepsy, Fractional Anisotropy, Apparent Diffusion Coefficient.

Correspondence to Heba Ibrahim Ali. Radiology department, Ain Shams University; Egypt. Tel.: +971508878210          e-mail:

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