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Functional imaging in temporal lobe epilepsy.

Jay J Pillai¹, Hadyn T Williams, Scott Faro

¹Division of Neuroradiology, Department of Radiology, Medical College of Georgia, Augusta, GA, USA. jpillai1@jhmi.edu

Seminars in Ultrasound, CT, and MR

|December 14, 2007

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Functional imaging, including SPECT, PET, fMRI, and DTI, is crucial for diagnosing and planning surgery in temporal lobe epilepsy (TLE). These techniques help lateralize the seizure focus and map critical brain functions like language and memory.

Area of Science:

Neurology
Radiology
Medical Imaging

Background:

Temporal lobe epilepsy (TLE) is a common neurological disorder requiring accurate diagnosis and surgical planning.
Identifying the precise location of seizure onset and understanding functional brain organization are critical for successful surgical outcomes in TLE.

Purpose of the Study:

To review the utility of various functional imaging modalities in the diagnosis and preoperative assessment of TLE.
To discuss the role of SPECT, PET, fMRI, and DTI in lateralizing TLE and mapping eloquent brain areas.

Main Methods:

Review of single-photon emission computed tomography (SPECT) for ictal and interictal analysis.
Discussion of positron emission tomography (PET) for interictal evaluation.
Exploration of blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and perfusion MRI for language and memory lateralization.

Related Experiment Videos

Evaluation of diffusion tensor imaging (DTI) as an emerging technique in TLE assessment.

Main Results:

SPECT and PET are established methods for lateralizing TLE.
fMRI and perfusion MRI are valuable for mapping language and memory functions in TLE patients, aiding in surgical planning.
DTI shows promise as a novel technique for evaluating TLE, offering insights into white matter integrity.

Conclusions:

Functional imaging plays a vital role in the comprehensive evaluation of TLE, guiding diagnosis and surgical interventions.
A multimodal imaging approach, integrating techniques like SPECT, PET, fMRI, and DTI, provides a more complete understanding of TLE and associated functional deficits.