title: Neuroimaging evaluation in refractory epilepsy.
abstract: OBJECTIVE
  To describe the application of neuroimaging analysis, compared to neuropsychological tests and video-electroencephalogram, for the evaluation of refractory epilepsy in a reference centre in Cali, Colombia.
  
  
  METHODS
  Between March 2013 and November 2014, 29 patients, 19 men and 10 women, aged 9-65 years and with refractory epilepsy, were assessed by structural and functional magnetic resonance imaging while performing tasks related to language, verbal and non-verbal memory. Also, volumetric evaluation was performed. A 1.5 Tesla magnetic resonance imaging scanner was used in all cases.
  
  
  RESULTS
  Neuroimaging evaluation identified 13 patients with mesial temporal sclerosis. The remaining patients were classified as: 10 patients with neoplastic masses, two patients with cortical atrophy, two patients with scarring lesions and two patients with non-structural aetiology. Among patients with mesial temporal sclerosis, comparison between techniques for lateralising the epileptogenic foci was made; the κ index between functional magnetic resonance imaging and hippocampi volumetry was κ=1.00, agreement between neuroimaging and video-electroencephalogram was good (κ=0.78) and comparison with a neuropsychological test was mild (κ=0.24).
  
  
  CONCLUSIONS
  Neuroimaging studies allow the assessment of functional and structural damage related to epileptogenic lesions and foci, and are helpful to select surgical treatment, conduct intraoperative neuronavigation techniques, predict surgical deficits and evaluate patient recovery.
authors.affiliation: Department of Radiology, Fundación Valle de Lili, Colombia.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Granados
authors.affiliation: Department of Radiology, Fundación Valle de Lili, Colombia.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Orejuela
authors.affiliation: Department of Radiology, Fundación Valle de Lili, Colombia syukierodriguez@gmail.com.
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Rodriguez-Takeuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003105:Colombia; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests
keywords: Epilepsy; magnetic resonance imaging; mesial temporal sclerosis