Neuroimaging in Pediatric Epilepsy

Abstract

Pediatric epilepsy presents with various diagnostic challenges. Recent advances in neuroimaging play an important role in the diagnosis, management and in guiding the treatment of pediatric epilepsy. Structural neuroimaging techniques such as CT and MRI can identify underlying structural abnormalities associated with epileptic focus. Functional neuroimaging provides further information and may show abnormalities even in cases where MRI was normal, thus further helping in the localization of the epileptogenic foci and guiding the possible surgical management of intractable/refractory epilepsy when indicated. A multi-modal imaging approach helps in the diagnosis of refractory epilepsy. In this review, we will discuss various imaging techniques, as well as aspects of structural and functional neuroimaging and their application in the management of pediatric epilepsy.

Use of Innovative SPECT Techniques in the Presurgical Evaluation of Patients with Nonlesional Extratemporal Drug-Resistant Epilepsy

“…For successful surgical planning, multiple tools are used to localize the seizure onset zone (SOZ), including video-electroencephalogram (V-EEG), Magnetic Resonance Imaging (MRI), Magnetoencephalography (MEG), Positron Emission Tomography (PET) scans, Single Photon Emission Computed Tomography (SPECT), and neuropsychological testing [ 9 ]. None of these tools alone has the needed sensitivity and specificity for localizing SOZ.…”

MRI Evaluation of Seizures in Pediatric Age Group Patients in a Rural Hospital of Central India

“…Seizure's in children account for 1% of all visits to emergency department [5]. Common causes of seizure in children include cortical malformations such as lissencephaly, focal cortical dysplasia etc., neurocutaneous syndromes like neurofibromatosis type 1, sturge weber syndrome etc, trauma, infections, tumours, metabolic and electrolyte disturbances and mesial temporal sclerosis [6].…”

“…In recognizing brain pathology related to seizures, MRI is much more useful than CT, and so is the preferred imaging modality [5,6]. Major role of MRI is in identifying structural lesions.…”

“…MRI provides for much better anatomic resolution when compared to a CT scan, it allows for better visualization of temporal fossa. It so is capable of identifying pathologies such as mesial temporal sclerosis, certain vascular malformations, focal cortical dysplasia and small tumours which may not be picked up on CT [6].…”

“…MRS has proved to be a useful screening tool for pediatric seizure patients with inborn errors of metabolism and is being used to characterize the mass lesions detected on MRI. MRS has been found to be particularly useful in temporal lobe epilepsy and is valuable in determining prognosis for patients undergoing surgery for epilepsy [6].…”