April 2014

Introduction

Advanced MR Techniques in Epilepsy: Time for Implementation in Clinical Practice

Bruno P. Soares

Bruno P. Soares

The era of image guidance in epilepsy surgery was inaugurated with the advent of MRI and with the description of findings of mesial temporal sclerosis. A marked increase in seizure-free outcomes is achieved by identification and resection of a small, T2-bright hippocampus with loss of internal laminar architecture, sometimes accompanied by ipsilateral forniceal and/or mammillary body atrophy. Hopes were … more »

Brain

Apparent Diffusion Coefficient Mapping of the Hippocampus and the Amygdala in Pharmaco-Resistant Temporal Lobe Epilepsy

Quantitative Diffusion is used as a biomarker of the severity of hippocampal sclerosis
Pedro Gonçalves Pereira

Pedro Gonçalves Pereira

Chronic epilepsy affects about 1% of the world population. It is estimated that 1000 individuals per year with refractory epilepsy undergo evaluation for epilepsy surgery for every 50 million people in the developed world.1 MRI is essential for epilepsy surgery candidates.2 An identifiable epileptogenic structural lesion on … more »

Brain

3T MRI Quantification of Hippocampal Volume and Signal in Mesial Temporal Lobe Epilepsy Improves Detection of Hippocampal Sclerosis

Ana C. Coan

Ana C. Coan

Surgical treatment, with removal of the epileptogenic zone, remains the best therapeutic option for patients with pharmacoresistant focal epilepsies. Mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis (HS) is the epileptic syndrome with the best surgical outcome, with up to 60% of patients seizure-free 5 years after the procedure.

The advent of MRI in the 1980s allowed the in … more »

Brain

Multisection Proton MR Spectroscopy for Mesial Temporal Lobe Epilepsy

Aristides Capizzano

Aristides A. Capizzano

Proton MR spectroscopy (MRS) studies of patients with temporal lobe epilepsy (TLE) have consistently shown reduced concentration of the neuronal marker N-acetylaspartate (NAA) in the medial temporal lobe ipsilateral to the seizure focus. These findings not only replicate information available from the presence of hippocampal sclerosis (HS) on conventional MRI, but have also been detected in normal-appearing temporal lobes1–4 and in … more »

Pediatrics

Diffusion Tensor Imaging Assessment of the Epileptogenic Zone in Children with Localization-Related Epilepsy

Elysa Widjaja

Elysa Widjaja

Epilepsy surgery may be the only treatment option to achieve seizure freedom in patients with medically refractory localization-related epilepsy, also known as focal epilepsy. However, the success of epilepsy surgery is in part dependent on the identification of a lesion on MRI. Patients who have a lesion seen on MRI are more likely to achieve better seizure outcome following epilepsy surgery … more »

Brain

Detection of Mesial Temporal Lobe Hypoperfusion in Patients with Temporal Lobe Epilepsy by Use of Arterial Spin Labeled Perfusion MR Imaging

Ronald I. Wolf

Ronald I. Wolf

Complex partial seizures, often arising in the temporal lobe, are the most common etiology of medically intractable acquired epilepsy in adults, but seizure foci can be difficult to lateralize let alone localize. These patients typically undergo multimodality testing, including structural MRI, EEG, PET, fMRI and/or intracarotid amytal testing, and in some cases ictal or interictal SPECT and proton MR … more »

Special Collections

Special Collection: Neuroimaging of Epilepsy

Collection Cover

Collection Cover

AJNR’s latest Special Collection reviews epilepsy neuroimaging and is available to Digest readers on an open-access basis. Dr. Lucien Levy, an AJNR Senior Editor, completed this wonderful collection of articles shortly before passing away. Always patient and meticulous, he included over 100 articles previously published in AJNR. This is evidence not only of the topic’s relevance, but also of the many contributions of ASNR members … more »