Neuroimaging in Epilepsy

The goal of this article is to review the use of neuroimaging in the treatment of new-onset seizures and epilepsy. The article will focus predominantly on MRI because this is the most common modality, but it will also review others that are often used in individuals being considered for epilepsy surgery. The article also reviews common causes of epilepsy and their appearance on imaging and various imaging tools that can be combined to assist in the care of people with epilepsy.

MRI has revolutionized the ability to diagnose the cause of many forms of epilepsy. However, to maximize the diagnostic power of MRI, it is essential to order the correct imaging sequences. In this article, the harmonized neuroimaging of epilepsy structural sequences (HARNESS) MRI protocol proposed by the International League Against Epilepsy is discussed.

MRI is the preferred imaging modality to identify lesions associated with epilepsy. Protocols should include thin-cut, no-gap sequences to permit the identification of small epileptogenic lesions, and studies should be reviewed with an understanding of all the clinical information to help guide the identification of potential lesions.