title: [Role of functional neuroimaging in the surgical treatment of epilepsy].
abstract: Functional neuroimaging is one of the most progressing fields in neuroscience and clinical neurological practice. It has also been contributing to the diagnosis and treatment of epilepsy. Intracranial electroencephalography (iEEG) is the gold standard for the diagnostic localization of the epileptogenic zone in the surgical treatment of epilepsy. Currently, no other modalities, including novel functional neuroimaging modalities, are superior to iEEG in sensitivity and spatial resolution. However, iEEG is an invasive procedure and its clinical usefulness is dependent on appropriate coverage of the epileptogenic zone. In this review article, the author discusses the principles of decision making in surgical indication and procedures by presenting clinical cases and evaluating the significance of functional neuroimaging in these processes; the review focuses on magnetoencephalography, 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography, and single photon emission computed tomography. The characteristics, advantages, and disadvantages of each modality are summarized. In some cases, but not all, functional neuroimaging modalities help avoid invasive iEEG without worsening surgical outcome and aid in determining the coverage area of iEEG, thereby resulting in better outcome and less complication.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kawai
mesh_terms: D001931:Brain Mapping; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D015225:Magnetoencephalography / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods