Maturation and abnormalities of white matter in children with epilepsy

Abstract

Epilepsy is a disabling neurological disorder, affecting both children and adults. Up until the introduction of MRI, epilepsy has always been considered as a disease of gray matter. Consequently, white matter defects in epilepsy have received little attention. Especially the investigation of white matter in children with epilepsy is essential, as white matter maturation continuous until late adolescents and white matter damage could possibly disturb this maturation process. The aim of this thesis was to obtain a better insight into white matter maturation and disturbances of white matter in children and adolescents with partial epilepsy. The majority of the studies discussed in this thesis reported a lack of white matter volume increase with age in children with partial epilepsy and decreased white matter volumes in adults with partial epilepsy. Furthermore in both children and adolescents decreased FA values, increased perpendicular diffusivity and increased mean diffusivity in a variety of white matter tracts, have been found. These diffusion abnormalities seem irreversible, as they persist after seizure control. The exact meaning of these diffusion disturbances are still unknown, however, myelin or axon abnormalities are being suggested.