NEUROIMAGING IN EPILEPSY SURGERY - A REVIEW

In recent years there has been a shift away from invasive monitoring, with more emphasis on the role of neuroimaging, in the selection of pa tients for epilepsy surgery, Although video-EEG is essential to confir m the diagnosis, and to determine the ictal onset, neuroimaging, in pa rticular magnetic resonance imaging (MRI), forms the basis for selecti on of most surgical candidates. MRI, using visual analysis, is able to detect hippocampal sclerosis, the most common cause of temporal lobe epilepsy, in the majority of patients with this condition, with quanti tative MRI increasing the sensitivity of this imaging technique, Other lesions readily detected on MRI include dysplasia, neuronal migration disorders and cavernomas, Studies have shown that the best postoperat ive results: are achieved in patients with a lesion visible on MRI, Fu nctional imaging, both single photon emission computed tomography (SPE CT), in particular ictal SPECT, and photon emission tomography (PET), are important ancillary investigations providing valuable corroborativ e evidence of a seizure focus.