Advances in Brain Imaging Techniques for Patients With Intractable Epilepsy

Intractable epilepsy, also known as drug resistance or refractory epilepsy, is a major problem affecting nearly one-third of epilepsy patients. Surgical intervention could be an option to treat these patients. Correct identification and localization of epileptogenic foci is a crucial preoperative step. Some of these patients, however, have no abnormality on routine magnetic resonance imaging (MRI) of the brain. Advanced imaging techniques, therefore, can be helpful to identify the area of concern. Moreover, a clear delineation of certain anatomical brain structures and their relation to the surgical lesion or the surgical approach is essential to avoid postoperative complications, and advanced imaging techniques can be very helpful. In this review, we discuss and highlight the use of advanced imaging techniques, particularly positron emission tomography (PET)-MRI, single-photon emission computed tomography, functional MRI, and diffusion tensor imaging-tractography for the preoperative assessment of epileptic patients.

Automated summary

Intractable epilepsy, affecting nearly one-third of epilepsy patients, presents a major challenge. Surgical intervention may be considered for these patients, highlighting the importance of advanced imaging techniques in preoperative assessment, particularly for cases where routine MRI shows no abnormality. Accurate identification of epileptogenic foci and clear delineation of relevant brain structures are crucial to avoid postoperative complications.