Annals of Indian Academy of Neurology
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ARTICLE
Year : 2014  |  Volume : 17  |  Issue : 5  |  Page : 56-64

Functional neuro-imaging as a pre-surgical tool in epilepsy


Kellaway Section of Neurophysiology, Department of Neurology, Baylor College of Medicine; Kellaway Section of Neurophysiology, Neurology Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, USA

Correspondence Address:
Zulfi Haneef
Department of Neurology, Baylor College of Medicine, Peter Kellaway Section of Neurophysiology, One Baylor Plaza, MS NB302, Houston, Texas 77030
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.128659

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Functional neuro-imaging techniques are helpful in the pre-surgical evaluation of epilepsy for localization of the epileptogenic zone as ancillary tools to electroencephalography (EEG) and magnetic resonance imaging (MRI) or when other localization techniques are normal, non-concordant or discordant. Positron emission tomography (PET) and ictal single photon emission computed tomography (ictal SPECT) imaging are traditional tests that have been reported to have good sensitivity and specificity although the results are better with more expertise as is true for any technique. More recently magnetoencephalogram/magnetic source imaging (MEG/MSI), diffusion tensor imaging and functional magnetic resonance imaging (fMRI) have been used in localization and functional mapping during the pre-surgical work-up of epilepsy. Newer techniques such as fMRI-EEG, functional connectivity magnetic resonance imaging and near infra-red spectroscopy, magnetic resonance spectroscopy and magneto nanoparticles hold promise for further development that could then be applied in the work-up of epilepsy surgery. In this manuscript, we review these techniques and their current position in the pre-surgical evaluation of epilepsy.


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