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[Functional neuroimaging in adults].

P Ryvlin1, F Mauguière

  • 1Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique, 59 boulevard Pinel, 69000 Lyon, France. ryvlin@cermep.fr

Revue Neurologique
|August 28, 2004
PubMed
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This summary is machine-generated.

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Functional neuroimaging techniques like PET and SPECT show promise for drug-resistant epilepsy surgery planning. However, more impact studies are needed to validate their clinical use and guide evidence-based guidelines for epilepsy treatment.

Area of Science:

  • Neurology
  • Medical Imaging
  • Epileptology

Background:

  • Drug-resistant partial epilepsy presents challenges, especially for surgical planning.
  • Various functional neuroimaging techniques are available but their clinical impact is not well-established.
  • Consensus on the optimal role of these techniques remains elusive.

Purpose of the Study:

  • To review the current evidence on functional neuroimaging techniques for drug-resistant partial epilepsy.
  • To assess the potential contributions and limitations of PET, SPECT, MRS, and fMRI.
  • To highlight the need for impact studies to guide clinical practice.

Main Methods:

  • Review of existing literature on functional neuroimaging in epilepsy surgery.
  • Analysis of studies utilizing [18F]-FDG PET, [11C]-flumazenil (FMZ) PET, [11C]-alpha-methyl-tryptophane (AMT) PET, SPECT, MRS, and fMRI.

Related Experiment Videos

  • Evaluation of data regarding prediction of surgical outcomes and localization of epileptogenic zones.

    • Main Results:

    • [18F]-FDG PET shows robust data for predicting surgical failures in temporal lobe epilepsy.
    • [11C]-FMZ PET, [11C]-AMT PET, and SPECT show potential in neocortical epilepsy, particularly tuberous sclerosis.
    • Functional MRI (fMRI) can serve as an alternative to Wada testing for language lateralization.

    Conclusions:

    • Functional neuroimaging techniques offer valuable adjunct information for epilepsy surgery planning, especially in MRI-negative cases.
    • Further multicentric impact studies are crucial for developing evidence-based guidelines.
    • Careful interpretation is needed to avoid misidentification of the epileptogenic zone.