title: Structural imaging in children with chronic focal epilepsy: diagnostic algorithms and exploration strategies.
abstract: Malformations of cortical development, especially focal cortical dysplasia in infants and children, and hippocampal sclerosis in adolescents with epilepsy are frequent lesions, but they are overlooked on standard MRI. In infants, errors in the interpretation of MRI in epilepsy can be attributed to MRI signal changes due to ongoing myelination. Poor technique, perceptual misses, incomplete knowledge and poor judgment are, however, other likely sources of errors when reading MRIs. This review covers MRI search strategies, i.e., how to conduct MRI examinations in epilepsy and what to expect in the structural MRI of an infant or child with focal epilepsy. Exploiting increased sensitivity, false positive results can be avoided in the light of a clinical hypothesis, possibly isolating a localized brain area by seizure semiology, EEG, and sometimes PET prior to MR reading.
authors.affiliation: MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany. Electronic address: friedrich.woermann@mara.de.
authors.forename: Friedrich G
authors.initials: FG
authors.lastname: Woermann
authors.forename: Gilbert
authors.initials: G
authors.lastname: Vézina
mesh_terms: D000465:Algorithms; D001921:Brain / Q000002:abnormalities / Q000473:pathology; D001927:Brain Diseases / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging