title: Combining advanced neuroimaging techniques in presurgical workup of non-lesional intractable epilepsy.
abstract: OBJECTIVE
  The rationale for this case report is to assess the degree of congruency between the results of several advanced functional, metabolic, and structural neuroimaging techniques used in patients with MRI-negative focal epilepsy.
  
  
  METHODS
  We investigated the presurgical evaluation and post-operative outcome of a patient with intractable, extratemporal epilepsy. Because the habitual seizures in this patient could be easily induced, six, advanced, neurodiagnostic techniques were successively applied (SISCOM, ictal FDG-PET, ictal fMRI, postictal diffusion-weighted imaging, voxel-based morphometry, and MRS imaging).
  
  
  RESULTS
  The findings for the neuroimaging methods investigated, within the left central region, were fairly congruent. Subsequent, invasive EEG recordings revealed a seizure-onset zone at the site where most of the neuroimaging had shown abnormal findings. The surgical removal of the epileptogenic zone, as defined by concordant neuroimaging and SEEG data, resulted in seizure-free postoperative outcome. Histopathological findings revealed mild focal cortical dysplasia.
  
  
  CONCLUSIONS
  Great efforts should be made to combine most of the advanced neuroimaging methods in the preoperative assessment of non-lesional epilepsy surgery candidates.
authors.affiliation: Department of Neurology, Brno Epilepsy Center, Czech Republic. mbrazd@med.muni.cz
authors.forename: Milan
authors.initials: M
authors.lastname: Brázdil
authors.forename: Michal
authors.initials: M
authors.lastname: Mikl
authors.forename: Pavel
authors.initials: P
authors.lastname: Chlebus
authors.forename: Marta
authors.initials: M
authors.lastname: Pazourková
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Novák
authors.forename: Jan
authors.initials: J
authors.lastname: Chrastina
authors.forename: Jirí
authors.initials: J
authors.lastname: Prásek
authors.forename: Karol
authors.initials: K
authors.lastname: Bolcák
authors.forename: Dagmar
authors.initials: D
authors.lastname: Fojtíková
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Horký
authors.forename: Jan
authors.initials: J
authors.lastname: Tomcík
authors.forename: Eva
authors.initials: E
authors.lastname: Lzicarová
authors.forename: Ivan
authors.initials: I
authors.lastname: Rektor
mesh_terms: D000328:Adult; D003952:Diagnostic Imaging; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18