Neuroimaging of epilepsy.

Area of Science:

• Neurology
• Neurosurgery
• Medical Imaging

Background:

• Detecting pathological abnormalities in surgical specimens for epilepsy diagnosis can be challenging.
• Accurate diagnosis necessitates shared preoperative information between neuropathologists and clinicians regarding resected brain tissue.

Purpose of the Study:

• To review the utility of structural, functional, and electrophysiological neuroimaging techniques for preoperative visualization of epileptogenic areas.
• To highlight the importance of multimodal imaging in improving the diagnosis of epilepsy-related pathological abnormalities.

Main Methods:

• Magnetic Resonance Imaging (MRI) for structural abnormalities in epilepsy.
• Positron Emission Tomography (PET) and Single-Photon Emission Computed Tomography (SPECT) for functional epileptic foci detection.
• Electrophysiological neuroimaging, including computerized voltage topographic mappings and multimodal image-guided interventions (electrocorticography, PET, MRI).

Main Results:

• MRI is highly sensitive for structural abnormalities in partial or localization-related epilepsy.
• PET and SPECT detect subtle functional changes related to epilepsy, potentially identifying MRI-invisible epileptogenic areas.
• Multimodal imaging, especially coregistered PET/SPECT with MRI and statistical parametric mappings, enhances detection of epileptic foci.

Conclusions:

• Neuroimaging provides crucial visual clarification of structural, functional, and electrophysiological information in epilepsy patients.
• Multimodal image-guided interventions allow precise collection of findings during surgery.
• This integrated neuroimaging approach is key for diagnosing underlying pathological abnormalities in resected brain tissue.