Advances in the localization of epileptic loci for surgical resection

Patients with epilepsy have traditionally been treated medically, but medical management alone has frequently been insufficient in patients with intractable complex partial seizures. Surgery provides an alternative for optimum seizure control. Up to this time, however, successful surgical outcomes relied upon invasive techniques such as depth and subdural electrodes. On the forefront of research in neuroimaging are two new noninvasive techniques already showing impressive results in cerebral localization. Positron emission tomography (PET), which is based on cerebral glucose utilization, identifies hypometabolic regions correlating with epileptiform loci. Magnetic resonance (MR) imaging uses magnetic fields to produce cerebral images. MR may detect structural lesions not found by other diagnostic tests. These two advances, in conjunction with conventional diagnostic testing, provide valuable data regarding the localization of epileptiform loci. The nurse's expertise and support for the patient throughout the diagnostic and perioperative phase are demonstrated in a case study.