Neuroimaging in the diagnosis of partial epilepsy

Functional neuroimaging studies are essential in the evaluation of individuals with partial epilepsy syndromes. Magnetic resonance spectroscopy(MRS) allows us to investigate cerebral metabolites and some Reduction in various metabolite concentrations has proven to be prognostieally valuable no structure abnormality is identified. PET using deoxyglueose demonstrates areas of reduced glucose metabolism, which are the hallmark of epileptogenie zones and usually extend beyond the underlying anatomical region. It is useful in temporal lobe epilepsy for lateralization, however, results extratemporal lobe epilepsy have been less favorable. More promising is the use of benzodiazepine receptor ligands, which are reduced in the epileptogenie zone in a more restricted distribution. This appears to be helpful in the localization of extratemporal seizure foci. Peri-ietal SPECT measures increases blood flow during the ietal event and is beneficial in patients with normal MRI studies to determine lateralization and localization of ietal onset zone.