Diffusion-weighted magnetic resonance imaging (dMRI) is a unique tool, which allows non-invasive in-vivo assessment of the white matter integrity and characterization of the brain maturation process in normal and abnormal subjects. In this review, we briefly present dMRI techniques and methodologies for non-experts and we describe recent studies investigating the use of dMRI in pediatric epilepsy. The study of white matter connections can guide us in localizing epileptic foci. Moreover, it has been proven sensitive to white matter-invisible lesions, network reorganization, the effects of seizures on the brain network, and the development of lesions in children and adults. Taken together, the results reviewed here suggest that dMRI is a valuable tool for assessing childhood epilepsy. However, studying dMRI in pediatric population is a challenge due to the high variability between age groups. In the quest for a deeper understanding of childhood epilepsies and brain abnormalities, dMRI protocols should be tested to determine the most sensitive parameters.
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