8. What Can Neuroimaging Tell Us?
- John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery2 and
- Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology3
Published Online: 10 JAN 2014
Copyright © 2014 John Wiley & Sons, Ltd.
How to Cite
Novotny, E. J. (2014) What Can Neuroimaging Tell Us?, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch8
University of Washington, Seattle, WA, USA
Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Published Online: 10 JAN 2014
- Published Print: 14 FEB 2014
Print ISBN: 9781118456941
Online ISBN: 9781118456989
- functional magnetic resonance imaging;
- magnetic resonance imaging;
- positron emission tomography;
Magnetic resonance structural neuroimaging is key in the workup of acquired epilepsy. Structural lesions that cause focal epilepsy include vascular malformations, atrophic lesions including infarcts and mesial temporal sclerosis, neoplasms, and developmental malformations. Imaging technology has substantially improved over the last decade. Magnetic resonance imaging (MRI) at 3 T using novel hardware and imaging sequences can identify the structural causes of epilepsy in nearly 20% of patients in whom previous studies were unremarkable. Diffusion imaging data can identify microstructural abnormalities of white matter tracts. Imaging is also used in combination with electrophysiological data to localize seizures and brain function when neurosurgical treatment is considered. 2-[18 F] Fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and ictal single-photon-emission computed tomography (SPECT) identify epileptic zones by locating alteration of metabolism and cerebral blood flow. Language, sensorimotor, and visual system functional networks can be identified by fMRI.