The role of functional neuroimaging in pre-surgical epilepsy evaluation

• Main Authors: Francesca ePittau, Frédéric eGrouiller, Laurent eSpinelli, Margitta eSeeck, Christoph M Michel, Serge eVulliemoz
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2014-03-01
• Series: Frontiers in Neurology
• Subjects: Functional Neuroimaging; Neuroimaging; network; PET; EEG-fMRI; MRS Spectroscopy.
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00031/full

The prevalence of epilepsy is about 1% and one-third of cases do not respond to medical treatment. In an elegible subset of patients with drug-resistant epilepsy, surgical resection of the epileptogenic zone is the only treatment that can possibly cure the disease. Non-invasive techniques provide information for the localisation of the epileptic focus in the majority of cases, whereas in others invasive procedures are required. In the last years non-invasive neuroimaging techniques, such as simultaneous recording of functional magnetic resonance imaging and electroencephalogram (EEG-fMRI), Positron-Emission-Tomography (PET), Single Photon Emission Cerebral Tomography (SPECT), electric and magnetic source imaging (MSI, ESI), spectroscopy (MRS), have proven their usefulness in defining the epileptic focus. The combination of these functional techniques can yield complementary information and their concordance is crucial for guiding clinical decision, namely the planning of invasive EEG recordings or respective surgery. The aim of this review is to present these non-invasive neuro-imaging techniques, their potential combination and their role in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy.