Neuroimaging in Epilepsy Yukihiro Yamao 1 , Takeharu Kunieda 1 , Takayuki Kikuchi 1 , Masao Matsuhashi 2 , Nobukatsu Sawamoto 3 , Riki Matsumoto 3 , Tomohisa Okada 4 , Susumu Miyamoto 1 , Akio Ikeda 3 1Department of Neurosurgery, Kyoto University Graduate School of Medicine 2Human Brain Research Center, Kyoto University Graduate School of Medicine 3Department of Neurology, Kyoto University Graduate School of Medicine 4Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine Keyword: MRI , epileptic focus , brain function , epilepsy surgery , brain network pp.573-581
Published Date 2013/5/1
DOI https://doi.org/10.11477/mf.1416101497
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 It is now recommended that magnetic resonance imaging (MRI) or computed tomography (CT) be carried out in all patients with at least partial- and hopefully also generalized epilepsy to help identify intracranial lesions, such as hippocampal sclerosis, focal cortical dysplasia, brain tumor, cavernous malformation, and arteriovenous malformation. In order to identify epileptic focus, other neuroimaging tools, such as positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetoencephalography (MEG), are also useful, because an epileptogenic area is not necessarily located within these intracranial lesions. With regard to epilepsy surgery, neuroimaging is also required for the identification of functionally essential cortices, such as motor and language areas. MEG and functional MRI are noninvasively, and tractography with diffusion-weighted imaging (DWI) is also useful for visualizing relevant white matter tracts. Recently, it has been reported that the cortico-cortical network plays an important role in preservation of brain function. Thus, cortico-cortical evoked potentials (CCEP) and resting state fMRI are candidate methods to help clarify brain network. While good seizure control is an important treatment outcome for patients with intractable partial epilepsy, the preservation of brain function is equally important. For this reason, further development and clinical application of sophisticated imaging technique are required.

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