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Updated: Jul 4, 2026
09:57
Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Identifying seizure-onset zone and visualizing seizure spread by fMRI: a case report
Tibor Auer1, Katalin Veto, Tamás Dóczi
1Department of Neurosurgery, University of Pécs, Hungary.
Summary
Functional MRI visualized seizure onset and spread in epilepsy, revealing brain activity changes before clinical symptoms. This supports the pre-ictal state and aids in presurgical evaluation for drug-resistant epilepsy.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Functional Magnetic Resonance Imaging (fMRI)
Background:
- Epileptic seizures involve abnormal brain activity, but visualizing the precise onset and spread remains challenging.
- Understanding the seizure-onset zone is crucial for effective treatment, particularly in drug-resistant epilepsy.
Observation:
- A 20-year-old woman with simple partial seizures underwent functional MRI (fMRI).
- Pixelwise correlation with an internal reference curve and lag time mapping were used to analyze BOLD signal changes.
- The study aimed to visualize haemodynamic changes during an epileptic seizure.
Findings:
- fMRI revealed initial activation in the insular cortex preceding clinical seizure onset by over a minute.
- Widespread brain activation, including the insular cortex, motor areas, caudate nucleus, and thalamus, was observed.
- The study identified a pre-ictal phase, with significant brain activity preceding observable clinical symptoms.
Implications:
- This study demonstrates whole-brain activity mapping in time and space during seizures.
- Findings support the existence of a pre-ictal state in epilepsy.
- These advanced imaging techniques could be valuable for presurgical evaluation in patients with drug-resistant epilepsy.
Related Concept Videos
01:13Seizures: Classification
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:20Seizures l: Introduction
Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
01:19Seizures ll: Types
Seizures are sudden bursts of abnormal electrical discharge in the brain that interfere with normal function. They are commonly divided into three groups: focal seizures, generalized seizures, and other types that do not fit neatly into either category.Focal SeizuresFocal seizures begin in a single brain region. When awareness is preserved, they are called focal aware seizures and may cause sensations such as tingling, unusual smells, or flashing lights. When awareness is impaired, they are...