title: Multimodal imaging in nonlesional medically intractable focal epilepsy.
abstract: Identification and localization of epileptogenic zone (EZ) is vital in patients with medically-intractable focal epilepsy, who may be candidates for potentially curative resective epilepsy surgery. Presence of a lesion on magnetic resonance imaging (MRI) influences both diagnostic classification and selection for surgery. However, the implications for MRI-negative cases are not well-defined for such patients. Most of these patients undergo invasive long-term Electroencephalography recordings before a final decision regarding resection is possible. Recent developments in structural and functional neuroimaging which include quali-quantitative MRI, Positron Emission Tomography, Single Photon Emission Computed Tomography, and functional MRI have significantly changed presurgical epilepsy evaluation. Source analysis based on electrophysiological information, using either EEG or magnetoencephalography are also promising in order to noninvasively localize the EZ and to guide surgery in medically-intractable focal epilepsy patients that exhibit nonlesional MRI. This chapter aims to review the value of the combined use of structural and functional imaging techniques, and how this multimodal approach improves both selection of surgical candidates and post-operative outcomes in medically-intractable nonlesional focal epilepsy.
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Lilia Maria
authors.initials: LM
authors.lastname: Morales-Chacon
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Carlos A.
authors.initials: CA
authors.lastname: Sanchez-Catasus
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Margarita
authors.initials: M
authors.lastname: Minou Baez Martin
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rodriguez Rojas
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Lorigados Pedre
authors.affiliation: Epilepsy Surgery Program, International Center for Neurological Restoration (CIREN), Ave 25 # 15805 % 158 and 160, Playa 11300, Havana Cuba.
authors.forename: Barbara
authors.initials: B
authors.lastname: Estupiñan Diaz
mesh_terms: D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000601:surgery; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D018579:Patient Selection; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D017211:Treatment Failure