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A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
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Recent developments in imaging of epilepsy.

Roland Wiest1, Roland Beisteiner2

  • 1Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.

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|May 21, 2019
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Summary
This summary is machine-generated.

Peri-ictal imaging, particularly MRI, aids in diagnosing seizures and planning epilepsy treatments. Advanced techniques like focused ultrasound (FUS) show promise for minimally invasive epilepsy therapies.

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Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Imaging is crucial for diagnosing epilepsy and guiding presurgical evaluations.
  • The role of imaging in emergency seizure diagnosis and minimally invasive therapies is evolving.

Purpose of the Study:

  • To review peri-ictal imaging findings for emergency differential diagnosis.
  • To explore image-guided therapies for epilepsy and its comorbidities.

Main Methods:

  • Computed tomography (CT) and Magnetic Resonance Imaging (MRI) for perfusion changes.
  • Advanced MRI techniques (arterial spin labeling, diffusion-weighted, susceptibility-weighted).
  • Image-guided focused ultrasound (FUS) for tissue ablation and drug delivery.

Main Results:

  • Peri-ictal perfusion changes on CT/MRI can distinguish ictal stroke mimics from acute ischemic stroke.
  • Postictal perfusion is often normal, limiting its diagnostic value for stroke differentiation.
  • Advanced MRI techniques offer higher sensitivity in differentiating stroke mimics.
  • FUS demonstrates potential for ablating epileptogenic tissue and enabling targeted drug delivery via blood-brain barrier opening.

Conclusions:

  • MRI is the preferred imaging modality for peri-ictal findings and differential diagnosis.
  • Combining MRI techniques with FUS presents novel therapeutic strategies for epilepsy.