What is the preoperative evaluation of epilepsy? (2)

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PET (positron emission tomography): a nuclear medicine imaging technology. About 60% of frontal lobe epilepsy and of the frontal lobe of the

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PET (positron emission tomography): a nuclear medicine imaging technology. About 60% of frontal lobe epilepsy and of the frontal lobe of the interictal PET showed low metabolism. PET can be used as a guide for the localization of epileptic foci, and can also be used to determine the location of intracranial electrode placement, but the site of PET's low metabolism is not necessarily epileptic.

MEG (magnetoencephalography): with high temporal and spatial resolution, it can detect epileptic foci with diameter less than 3mm, and the accuracy of locating epileptogenic foci is about 50-70%. MEG is also used to locate functional areas.

Wada test: by cerebral angiography, carotid artery injection of Isoamyl phenobarbital, side position of language, language function is in the left hemisphere and in the right hemisphere, in order to determine the relationship between epilepsy and language function.

During the operation, the patients were evoked by general anesthesia. After the general anesthesia, the cortex was stimulated by the electric current. Also used to locate functional areas.

Intraoperative cortical EEG: during the shallow anesthesia, the electrode slices were directly contacted with the cerebral cortex to monitor the epileptic wave and determine the epileptic foci. However, the monitoring of epileptic wave is intermittent discharge, the significance of the localization of epileptic foci is controversial.

In conclusion, the localization of epileptic foci depends on many means, noninvasive and invasive. There is no need to have a biopsy if the lesion can be located without a seizure. 1-2 examination can locate epileptic foci without more examination. (end)

 

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