MRI AND MAGNETIC SOURCE IMAGING IN TUBEROUS
SCLEROSIS
Curatolo P., Seri S., Verdecchia M.,
Bombardieri R.
Pediatric Neurology, Tor Vergata University
of Rome, Rome, Italy
In
Tuberous Sclerosis (TSC) MRI is a powerful tool in detecting and localizing
tubers which appears on the T2-weighted sequences as high
intensity areas. The concomitance presence of tubers and subependimal
nodules allow a definite diagnosis. The number and the localization of
tubers are genetically determined and may play a major role in the
variability of the neurological phenotype . In the past years we are made
significant progress in the understanding of the topographic relationship
among cortical tubers localized by MRI, electrical focal abnormalities by
EEG and hypometabolic areas demonstrated by PET. We can expand our
localizing ability in TSC by co-registration techniques. EEG-MRI fusioning
may provide important clues to the localization of epileptogenic areas even
in children with apparently synchronous spike-wave burst, showing that such
children may still be candidates for the epileptic surgery, if seizure
monitoring and EEG-MRI fusioning reveal seizure onset for only one anatomic
localization. Magnetic source imaging is a technique that combines
structural data provided by MRI and functional data provided by MEG. MEG
allows the identification of both the radial and tangential dypoles usually
missed by EEG. Several different techniques are used for non-invasive brain
mapping of sources location that can be displayed in the corresponding
anatomic structures, providing us more information about localization and a
better spatial-temporal resolution of the zone of cortical abnormalities.