Scalp and Intracranial EEG-fMRI in Epilepsy

Abstract

The choice of treatment for epilepsy patients relies on the identification and characterization of epileptic discharges and the type of epilepsy. The continued lack of a universally applied gold standard in presurgical evaluation has opened the ways to the investigation of new localizing and mapping tools in difficult cases including simultaneous EEG-fMRI, which can be used to map interictal and ictal discharges-related haemodynamic networks. The rapid increase in the literature on EEG-fMRI attests to its promised contribution in understanding of epilepsy-related and physiological networks of the brain. Its applications to investigate epileptic networks in humans have evolved since the mid 1990’s, and has yielded a better knowledge of the generation, propagation and particularly localisation of epileptic discharges, as well their interaction with the physiological and pathological brain networks. Here, we review the published literature to raise the awareness of different concepts pertaining to the applications of simultaneous EEGfMRI in epilepsy and discuss their potential impact on our understanding of epilepsy and its clinical management. We also describe our perspectives regarding possible future roles of the technique in epilepsy.a