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Scientific article
Review
Open access
German

Bildgebung in der prächirurgischen Epilepsiediagnostik

Published inNervenarzt
First online date2021-09-07
Abstract

While two thirds of patients with epilepsy become seizure-free with antiseizure medications, 30% remain drug-resistant. In drug-resistant focal epilepsy, epilepsy surgery offers an approximately 65% chance of becoming seizure-free; however, for a successful outcome of surgery a seizure focus must be precisely located, for which imaging techniques are essential. In recent years, the proportion of patients with apparently inconspicuous findings in magnetic resonance imaging (MRI) in the presurgical evaluation has increased. The sensitivity of MRI can be increased using special MRI sequences and MRI postprocessing techniques. Ictal and interictal source localization based on electroencephalography (EEG) and magnetencephalography (MEG) aim at determining the onset of interictal discharges and seizures. Nuclear medicine imaging techniques such as interictal positron emission tomography (PET) and ictal single photon emission computed tomography (SPECT) can detect chronic or acute seizure-related changes in brain metabolism and can indicate an epileptogenic focus even if MRI is inconspicuous. The results of these techniques are used to plan invasive EEG recordings and subsequently surgery. Concordant findings are associated with better surgical outcomes and show significantly higher rates of seizure freedomin the long-term seizure outcome.

eng
Keywords
  • EEG
  • Epilepsy
  • MRI
  • PET
  • Surgery
Citation (ISO format)
ILYAS-FELDMANN, Maria, VORDERWULBECKE, Bernd, STEINBRENNER, Mirja. Bildgebung in der prächirurgischen Epilepsiediagnostik. In: Nervenarzt, 2021. doi: 10.1007/s00115-021-01180-3
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Article (Published version)
Identifiers
ISSN of the journal0028-2804
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55downloads

Technical informations

Creation10/31/2021 10:17:00 AM
First validation10/31/2021 10:17:00 AM
Update time03/16/2023 2:19:08 AM
Status update03/16/2023 2:19:07 AM
Last indexation02/12/2024 12:18:02 PM
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