NEUROIMAGING IN THE EVALUATION OF CHILDREN AND ADOLESCENTS WITH INTRACTABLE EPILEPSY .2. NEUROIMAGING AND PEDIATRIC EPILEPSY SURGERY

The costs of epilepsy encompass all aspects of life, including medical , educational, and psychosocial, Adults with intractable epilepsy who undergo epilepsy surgery and have seizure-free outcomes still have sig nificant barriers in the attainment of improved quality of life, For t his reason, there is increasing interest in the recognition of childre n and adolescents with intractable epilepsy who might be epilepsy surg ery candidates, This is Part II of an article on the role of neuroimag ing in the evaluation of children and adolescents with intractable epi lepsy, Part I addressed the role of MRI in detecting the substrates of epilepsy (Pediatr Neurol 1997;17: 19-26); Part II elaborates on the s election process of pediatric patients who might benefit from epilepsy surgery, Although EEG remains the cornerstone of the evaluation proce ss, MRI, SPECT, and PET can play a pivotal role in the identification of the underlying epileptogenic focus and minimize the need for invasi ve EEG monitoring, Magnetic resonance spectroscopy and magnetoencephal ography are also innovative, noninvasive techniques which may aid in t he localization of the epileptogenic focus, Functional MRI scans may s oon replace invasive technologies in the identification of eloquent co rtex that should not be a part of the surgical resection. (C) 1997 by Elsevier Science Inc. All rights reserved.