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July2014 Vol.51 Issue:        3       (Supp.) Table of Contents
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Magnetic Resonance Spectroscopy in Idiopathic Generalized Epilepsies

Mervat Mostafa1, Foraysa Talaat1, Ihab Ismail2, Nevin Shalaby1,

Rania Hegazy2, Neveen El-Fayoumy3, Dalia Labib1

Departments of Neurology1, Radiology2, Clinical Neurophysiology Unit3, Cairo University; Egypt


Background: The absence of gross structural abnormalities on conventional brain imaging does not preclude the existence of subtle alterations on the neuronal level in case of idiopathic generalized epilepsy (IGE). Objective: To quantify neuronal dysfunction of the thalamus and prefrontal cortex in patients with IGE. Methods: A case control study carried out on 60 subjects; 30 patients with IGE and 30 healthy subjects, age and sex matched. Patients were divided into 3 groups: juvenile myoclonic epilepsy (JME); generalized tonic clonic seizures (GTCs) and childhood absence epilepsy (CAE). Proton magnetic resonance spectroscopy (H1MRS) was done to assess NAA and NAA/Cr in thalamus and prefrontal cortex. Results: A Significant reduction of NAA and NAA/Cr ratio in the thalamus of all IGE patients as well as individual groups compared with controls was found. JME patients had a statistically significant lower mean value of NAA /Cr ratio in prefrontal cortex in comparison to GTCs and CAE. Among all IGE patients and individual groups, a positive correlation was found between NAA& NAA/Cr ratio in the thalamus and prefrontal cortex. Conclusion: The thalamic frontal cortex reduction in NAA supports the notion of abnormal thalamo-cortical circuitry as a substrate of seizure generationin this form of epilepsy. A possible role can be played by the frontal lobe in the pathophysiology of the epileptogenic process in IGEs especially JME. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(3): 265-273]

Key Words: MRS, IGE, Epilepsy.

Correspondence to Nevin Mohieldin Shalaby. Department of Neurology, Cairo University. Tel.: +201001493242          Email:


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