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Clinical Cases and Reviews in Epilepsy

Could DTI alterations be different in temporal lobe epilepsy? Two case reports and a review of the literature

Review, 1 - 5
doi: 10.11138/ccre/2016.1.1.001
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Abstract
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Objective: diffusion tensor imaging (DTI) studies have demonstrated bilateral temporal and extratemporal alterations in white matter tracts in patients with refractory mesial temporal lobe epilepsy (rMTLE). Conversely, DTI data in patients with benign MTLE (bMTLE) have not been exhaustively investigated yet. Here we described clinical and DTI features of two patients together with a review of the current literature.
Methods: one patient with rMTLE and one with bMTLE are described. DTI was performed in each patient and compared to healthy volunteer. Mean diffusivity(MD) and fractional anisotropy (FA) in hippocampi and temporal lobe grey and white matter regions were measured. We also reviewed all the existing literature relevant to the understanding the role of DTI in MTLE using predefined search criteria from electronic databases (e.g., PubMed, Cochrane Library Database of Systematic Reviews).
Results: here we have found in rMTLE subject a FA lower in temporal white matter compared to bMTLE subject. These data are very closely to the unique study of DTI performed in bMTLE.
Conclusions: to date the majority of DTI studies in MTLE have been performed in rMTLE patients as highlighted in our review of the literature. Our two cases together with our previous DTI results in bMTLE support the hypotheses that DTI features may capture differences among MTLE patients.

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