Abstract

Intractable epilepsy, also known as drug resistance or refractory epilepsy, is a major problem affecting nearly one-third of epilepsy patients. Surgical intervention could be an option to treat these patients. Correct identification and localization of epileptogenic foci is a crucial preoperative step. Some of these patients, however, have no abnormality on routine magnetic resonance imaging (MRI) of the brain. Advanced imaging techniques, therefore, can be helpful to identify the area of concern. Moreover, a clear delineation of certain anatomical brain structures and their relation to the surgical lesion or the surgical approach is essential to avoid postoperative complications, and advanced imaging techniques can be very helpful. In this review, we discuss and highlight the use of advanced imaging techniques, particularly positron emission tomography (PET)–MRI, single-photon emission computed tomography, functional MRI, and diffusion tensor imaging–tractography for the preoperative assessment of epileptic patients.

Highlights

  • Temporary onset of signs and/or symptoms due to irregular excessive or synchronous neuronal activity in the brain is known as an epileptic seizure (Fisher et al, 2005)

  • We review different advanced imaging techniques that are useful to detect epilepsy lesions and outline their relations to nearby critical brain structures and highlight the value of these techniques in improving the outcome and safety of epilepsy surgery

  • Positron emission tomography is superior to conventional magnetic resonance imaging (MRI) in detecting mild malformations of cortical development, which was missed in up to 66% of patients by MRI, while detected in 77% of patients by positron emission tomography (PET) in some of the studies (Kim et al, 2011)

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Summary

Frontiers in Neuroscience

Correct identification and localization of epileptogenic foci is a crucial preoperative step. Some of these patients, have no abnormality on routine magnetic resonance imaging (MRI) of the brain. Can be helpful to identify the area of concern. A clear delineation of certain anatomical brain structures and their relation to the surgical lesion or the surgical approach is essential to avoid postoperative complications, and advanced imaging techniques can be very helpful. We discuss and highlight the use of advanced imaging techniques, positron emission tomography (PET)–MRI, single-photon emission computed tomography, functional MRI, and diffusion tensor imaging–tractography for the preoperative assessment of epileptic patients

INTRODUCTION
POSITRON EMISSION TOMOGRAPHY
PERFUSION MRI
DIFFUSION TENSOR IMAGING AND FIBER TRACTOGRAPHY
FUNCTIONAL MRI
Findings
CONCLUSION
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