[Contribution of MRI to the exploration of partial refractory epilepsy]

The development of MRI has modified clinical practices for patients with epilepsy. MRI examinations are highly contributive to the detection of structural brain abnormalities, and have a major impact on the management of patients with epilepsy. In addition to its major diagnostic role, MRI may help to assess prognosis in patients with refractory partial epilepsy. Structural abnormalities such as hippocampal sclerosis or malformations of cortical development are associated with medically refractory epilepsy. Furthermore, finding a focal lesion on MRI is a good prognostic factor in refractory patients who are candidates for surgery. The sensitivity of MRI to detect small brain lesions is currently excellent, but may be further improved by the use of high-resolution imaging, and new techniques such as quantitative methods or statistical parametric mapping (SPM). In the future, new emerging MR techniques will undoubtedly greatly contribute to improved presurgical management of patients with refractory partial epilepsy.