| Imaging in the surgical treatment of epilepsy. | |
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MedLine Citation:
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PMID: 20842185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Medically refractory focal epilepsy is potentially curable by surgery. This Review considers the application of recent advances in structural and functional brain imaging to increase the number of patients with epilepsy who are treated surgically, and to reduce the risk of complications arising from such intervention. Current optimal MRI of brain structure can identify previously undetectable lesions, with voxel-based and quantitative analyses further increasing the diagnostic yield. If MRI proves unremarkable, PET (with (18)F-fluorodeoxyglucose) and single-photon emission CT of ictal-interictal cerebral blood flow might identify the brain region that contains the epileptic focus. Magnetoencephalography plus simultaneous EEG and functional MRI can map the location of interictal epileptic discharges, thereby facilitating placement of intracranial recording electrodes to define the site of seizure onset. Functional MRI can also lateralize language and localize primary motor, somatosensory and language areas, and shows promise for predicting the effects of temporal lobe resection on memory. Tractography can visualize the main cerebral white matter tracts, thereby predicting and reducing surgery risk. Currently, displays of the optic radiation and pyramidal tracts are the most relevant for epilepsy surgery. Reliable integration of structural and functional data into surgical image-guidance systems is being pursued, and promises safer neurosurgery for epilepsy in the future. |
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Authors:
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John S Duncan |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2010-09-14 |
Journal Detail:
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Title: Nature reviews. Neurology Volume: 6 ISSN: 1759-4766 ISO Abbreviation: Nat Rev Neurol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-07 Completed Date: 2011-01-27 Revised Date: 2011-05-20 |
Medline Journal Info:
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Nlm Unique ID: 101500072 Medline TA: Nat Rev Neurol Country: England |
Other Details:
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Languages: eng Pagination: 537-50 Citation Subset: IM |
Affiliation:
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National Society for Epilepsy, Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, Queen Square, London, UK. j.duncan@ion.ucl.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Brain
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pathology,
radiography,
radionuclide imaging Brain Mapping* Diagnostic Imaging / classification, methods* Epilepsy / diagnosis*, etiology, surgery* Humans |
| Grant Support | |
ID/Acronym/Agency:
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//Medical Research Council; //Wellcome Trust |
| Comments/Corrections | |
Comment In:
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Nat Rev Neurol. 2011 Apr;7(4):1-2
[PMID:
21468101
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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