Neuroimaging and the Epilepsy Journey

This article reviews the modern pathway of epilepsy care with a focus on how neuroimaging supports treatment decisions and guides surgical intervention for patients who are drug-resistant. The article details the roles of noninvasive and invasive diagnostic approaches including structural computed tomography and MR imaging, video-scalp electroencephalography (EEG) monitoring, PET, ictal/interictal single-photon emission computed tomography, magnetoencephalography, and invasive EEG monitoring, and it describes how these modalities are integrated to localize the epileptogenic zone and target surgical resection, laser ablation, or neuromodulation. A detailed case study illustrates the practical application of multimodal presurgical evaluation and stereoelectroencephalography-guided resection.