Presurgical Assessment of the Epilepsies with Clinical Neurophysiology and Functional Imaging > Neurology

The objective of resective epilepsy surgery is the complete resection or complete disconnection of the epileptogenic zone, which is defined as the area of cortex indispensable for the generation of clinical seizures. Ideally this aim should be accomplished without damaging the "eloquent" cortex. The epileptogenic zone can currently not be measured directly. Therefore, a variety of diagnostic tools such as analysis of seizure semiology, neurophysiological techniques, functional testing as well as structural and functional neuroimaging are used to indirectly define the location and boundaries of the epileptogenic zone. These diagnostic methods define different cortical zones (symptomatogenic zone, irritative zone, ictal onset zone, stimulation induced seizure zone, functional deficit zone, and the epileptogenic lesion) which all are a more or less precise index of the location and extent of the epileptogenic zone. The ability to precisely define these zones is essential to best appreciate the topography of the epileptogenic zone. This volume provides an up to date and complete overview of the methods used in clinical neurophysiology as well as structural and functional imaging used to delineate these different zones currently as well as methods currently applied as research tools which may evolve to be used in clinical practice in the future.

Section 1. Overview.
1.1 Overview (F. Rosenow, H.O. Lüders).
Section 2. CNP Techniques Used in Presurgical Evaluation of the Epilepsies.
2.1 Non-invasive EEG in the definition of the irritative zone
2.2 Magnetoencephalography in the definition of the irritative zone
2.3 Invasive EEG in the definition of the irritative zone
2.4 Electrocorticography in the definition of the irritative zone: its role in the era of multi-channel EEG and modern neuroimaging
2.5 Automatic detection of interictal epileptiform discharges
2.6 Non-invasive EEG in the definition of the seizure onset zone
2.7 Invasive EEG in the definition of the seizure onset zone: subdural electrodes
2.8 Invasive EEG in the definition of the seizure onset zone: depth electrodes
2.9 Special recording techniques for detection of the seizure onset zone: DC shifts and high-frequency discharges
2.10 Ictal SPECT in the definition of the seizure onset zone
2.11 Automatic detection of epileptic seizures
2.12 Automatic seizure detection by ECG analysis
2.13 Cortical stimulation in the definition of the stimulation-induced aura zone
2.14 Video analysis for defining the symptomatogenic zone
2.15 CT scan and MRI in the definition of the epileptogenic lesion
2.16 PET scan in the interictal period: its contribution to evaluation of the functional-deficit and epileptogenic zones
2.17 The role of neuropsychological assessment in the presurgical evaluation of epilepsy surgery candidates
2.18 Intracarotid amobarbital test and fTCD in the lateralization of memory and language
2.19 Cortical stimulation in the definition of eloquent cortical areas
2.20 Cortical somatosensory evoked potential mapping
2.21 VEP in the definition of eloquent cortical areas
2.22 Auditory evoked potentials in the definition of eloquent cortical areas
2.23 Functional MRI in the definition of eloquent cortical areas
2.24 Event-related evoked potentials in the definition of eloquent cortical areas
2.25 Magnetic stimulation in the definition of eloquent cortical areas
Section 3. Presurgical Evaluation in Epilepsies of Different Etiologies.
3.1 Presurgical evaluation in patients with mesial temporal sclerosis
3.2 Presurgical evaluation in patients with tumors
3.3 Presurgical evaluation in patients with vascular malformations
3.4 Presurgical evaluation of patients with focal malformations due to abnormal cortical development (MCD)
3.5 Presurgical evaluation in patients with remote symptomatic epilepsy
3.6 Presurgical evaluation in patients with inflammatory lesions: meningitis, encephalitis, Rasmussen's syndrome
3.7 Presurgical evaluation in patients with hypothalamic hamartomas
3.8 Presurgical evaluation in patients with catastrophic epilepsy
Section 4. Research Studies and Future Advances.
4.1 fMRI in the evaluation of the irritative zone
4.2 EEG dipole analysis
4.3 Prediction of seizure occurrence by chaos analysis: technique and therapeutic implications
4.4 Cognition related potentials in the definition of functional deficit zones
4.5 Three-dimensional analysis of MRI
4.6 New PET tracers
4.7 Mechanisms and efficacy of deep brain stimulation in epilepsy
Subject Index.

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