Abstract
The management of patients with epilepsy is usually achieved through antiepileptic drugs (AED). However, it is essential to know if there is an underlying cause of epilepsy that may put patient’s life at risk, such as brain tumors, presenting with seizures as the first manifestation. The role of clinical neuroimaging was, for a long time, only to rule out underlying pathology causing epileptic seizures. Advances in magnetic resonance imaging have allowed detection of small malformations of cortical development (MCD), hippocampal sclerosis (HS), or other subtle brain lesions that can be resected in order to achieve seizure freedom. It is well known that patients with a detected epileptogenic lesion have a better prognosis after surgery than patients with negative imaging findings. Therefore, an accurate clinical neuroimaging evaluation in epilepsy is crucial for clinical management. Structural MR with dedicated protocol interpreted by expertise neuroradiologist is essential. Advanced MR techniques, discussed in this chapter, such as MR quantification, diffusion weighted MR imaging (DWI), diffusion tensor imaging (DTI), perfusion MR, functional MR (fMRI), MR spectroscopy (MRS), and nuclear medicine techniques (18F-FDG PET, SPECT and SISCOM), are also crucial in the evaluation of epilepsy.
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Abbreviations
- 18F-FDG:
-
18-fluoro-2-deoxyglucose
- ADC:
-
apparent diffusion coefficient
- AED:
-
Antiepileptic drugs
- AIDS:
-
Acquired immunodeficiency syndrome
- ASL:
-
Arterial Spin Labeling
- AVM:
-
Arteriovenous malformation
- BOLD:
-
Blood Oxygen Level-Dependent
- Cr:
-
Creatine
- CSI:
-
Chemical shift image
- CT:
-
Computer tomography
- DIR:
-
Double inversion recovery
- DTI:
-
Diffusion Tensor Imaging
- DWI:
-
Diffusion Weighted Imaging
- ECD:
-
ethyl cysteine dimer
- EEG:
-
Electroencephalography
- FCD:
-
Focal Cortical Dysplasia
- FLAIR:
-
Fluid attenuated inversion recovery
- fMRI:
-
Functional Magnetic Resonance Imaging
- GE:
-
Gradient echo
- HMPAO:
-
hexamethylpropylenaminooxime
- HS:
-
Hippocampal sclerosis
- ILAE:
-
International League Against Epilepsy
- IR:
-
Inversion recovery
- MAP:
-
Morphometric analysis program
- MCD:
-
Malformations of cortical development
- MELAS:
-
Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes syndrome
- MRI:
-
Magnetic Resonance Imaging
- MRS:
-
Magnetic Resonance Spectroscopy.
- MRSI:
-
multislice magnetic resonance spectroscopic imaging
- MTLE:
-
Mesial temporal lobe epilepsy
- NAA:
-
N-acetylaspartate
- NTLE:
-
Neocortical temporal lobe epilepsy
- PET:
-
Positron Emission Tomography
- PRES:
-
Posterior reversible encephalopathy syndrome
- rCBF:
-
relative cerebral blood flow
- SBM:
-
Surface-based morphometry
- SE:
-
Status epilepticus
- SEEG:
-
stereoelectroencephalography
- SISCOM:
-
Subtracted Ictal SPECT CO-registered to MRI
- SNR:
-
Signal-to-noise ratio
- SPECT:
-
Single Photon Emission Computed Tomography.
- STATSISCOM:
-
ictal SPECT with statistical ictal SPECT coregistered to MRI
- SWI:
-
Susceptibility weighted imaging
- TLE:
-
Temporal lobe epilepsy
- VBM:
-
Voxel-based morphometry
- VEEG:
-
Video electroencephalography
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Bargalló, N., Setoain, X., Carreño, M. (2019). Neuroradiological Evaluation of Patients with Seizures. In: Barkhof, F., Jäger, H., Thurnher, M., Rovira, À. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-68536-6_49
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