NEURORADIOLOGICAL METHODS AND FINDINGS IN PRESURGICAL EVALUATION OF EPILEPTIC CHILDREN

Epilepsy in childhood is often caused by morphological abnormalities a nd is frequently pharmacoresistant. Therefore it represents a challeng e to the neuroradiologist because early and accurate diagnosis of abno rmal morphology is the basis for planning surgical intervention with a high chance of controlling seizures and a low risk of complications. Both morphological (radiography, CT, MRI and angiography) and function al examinations [intracarotid amobarbital test (IAT)] are essential pa rts of the presurgical evaluation. In most cases MRI has proved to be most sensitive in detecting lesions except for some calcifications. Ro utine protocols for brain examinations are not sufficient, missing abo ut 22 % of lesions. Therefore a refined MRI and CT protocol is propose d. Even in very young children IAT can be performed al very low risk: these tests contribute highly valuable information about actual hemisp heric dominance and other functions in more than 80 % of procedures th at is indispensable if postoperative neurological and neuropsychologic al deficits are to be avoided.