8. What Can Neuroimaging Tell Us?

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery2 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology3
  1. Edward J. Novotny

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch8

Epilepsy

Epilepsy

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

Editor Information

  1. 2

    University of Washington, Seattle, WA, USA

  2. 3

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. Pediatric Epilepsy Program | Child Neurology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989

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Keywords:

  • epilepsy;
  • functional magnetic resonance imaging;
  • language;
  • magnetic resonance imaging;
  • positron emission tomography;
  • tractography

Summary

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.