Refractory epilepsies are syndromes for which therapies that employ two or more antiepileptic drugs, separately or in association, do not result in control of crisis. Patients may present focal cortical dysplasia or diffuse dysplasia and/or hippocampal atrophic alterations that may not be detectable by a simple visual analysis in magnetic resonance imaging. The aim of this study was to evaluate MRI texture in regions of interest located in the hippocampi, limbic association cortex and prefrontal cortex of 20 patients with refractory epilepsy and to compare them with the same areas in 20 healthy individuals, in order to find out if the texture parameters could be related to the presence of the disease. Of the 11 texture parameters calculated, three indicated the existence of statistically significant differences between the studied groups. Such findings suggest the possibility of this technique contributing to studies of refractory epilepsies.Keywords: refractory epilepsies, magnetic resonance, texture analysis.
REsumoEpilepsias refratárias compreendem síndromes para as quais as terapias que empregam duas ou mais drogas antiepilépticas, isoladamente ou em associação, não resultam no controle da frequência das crises. Portadores podem apresentar displasias corticais focais ou difusas e/ou alterações atróficas hipocampais que, em alguns casos, não são detectáveis por uma simples análise visual nas imagens de ressonância magnética. Nesse contexto, o objetivo deste estudo foi avaliar a textura de imagens de RM em regiões de interesse localizadas nos hipocampos, córtex de associação límbico e córtex pré-frontal de 20 pacientes com epilepsia refratária e compará-las às mesmas áreas de um grupo de 20 indivíduos sadios. Dos 11 parâmetros de textura calculados, três indicaram a existência de diferenças estatisticamente significantes entre os grupos estudados. Tais achados sugerem a possibilidade desta técnica contribuir para os estudos das epilepsias de difícil controle.Palavras-chave: epilepsias refratárias, ressonância magnética, análise de textura.Refractory epilepsies involve syndromes for which the therapies that employ two or more antiepileptic drugs (AEDs), separately or in association, do not result in control of crisis frequency 1,2 . In Brazil, among the people affected by epilepsy, totaling approximately 3 million, 30% are refractory to drug therapy FCD is characterized by alterations in the microarchi tecture of the cerebral cortex, in which dysmorphic neurons (giant, dysplastic) and balloon cells may or may not be ob served. The presence or absence of abnormal cells results in two possible classifications for FCD. In type 1 FCD, we can observe the loss of the laminar pattern of the cortex without the presence of abnormal cells; in type 2 FCD, in turn, there is the presence of dysplastic neurons or balloon cells asso ciated with loss of cortical lamination. In the magnetic reso nance imaging (MRI), the FCD findings include thickening of