Investigation of Blood-Brain-Barrier Breakdown Using Manganese Magnetic Resonance Imaging in Drug-Resistant Epilepsy

Exclusion Criteria

• •General exclusions:
• •Patients with epilepsy who are not surgical candidates
• •Significant structural brain abnormality such as a brain tumor, stroke, brain damage from head trauma or blood vessel abnormalities, on the baseline MRI scan.
• •Positive test for HIV
• •Pregnancy or breast-feeding
• •Claustrophobia to a degree that the subject would feel uncomfortable in the MRI machine.
• •Cannot lie on their back for at least two hours.
• •Risk for MRI scan, (e.g., any non-organic implant or other device such as a cardiac pacemaker or infusion pump or other metallic implants, objects or body piercings that cannot be removed, or history of being a welder or metal worker due to small metal fragments in the eye)
• •Unwilling to allow sharing and/or use in future studies of coded data that are collected for this study
• •MEMRI component specific exclusions (applicable only to patients participating in this arm of the study):
• •History of post-ictal psychosis or post-ictal aggression
• •Planning to get pregnant in the next 2 months
• •History of clinically significant liver or kidney disease that could potentially increase the risk of CNS damage due to manganese exposure
• •A history of drug or alcohol abuse/dependence (subjects scoring 8 or higher on the AUDIT scale)
• •Screening lab abnormalities demonstrating values more than 2 times the upper limit of normal for AST, ALT, bilirubin, alkaline phosphatase, BUN, creatinine
• •Previous presumed occupational exposure to manganese (i.e., having worked in a mine, foundry, smelter, dry cell battery manufacturing facility, or agriculture)
• •Allergy to manganese
• •On-going treatment with calcium-channel blocker
• •Iron-deficiency anemia
• •Personal history of Parkinson s Disease or Parkinsonism or presence of this disease in a 1st degree relative
• •Gadolinium enhanced MRI component specific exclusions (applicable only to patients participating in this arm of the study):
• •Estimated GFR \<60, tested within 1 week of scan
• •Allergy to gadolinium
• •Of note, patients who are ineligible for one arm of the study may still be eligible for and participate in the other arm of the study.