Role of fMRI in the decision-making process: epilepsy surgery for children

Journal of Magnetic Resonance Imaging : JMRI
Frédérique LiégeoisA Connelly

Abstract

Functional MRI (fMRI) is increasingly being used to evaluate children and adolescents who are candidates for surgical treatment of intractable epilepsy. It has the advantage of being noninvasive and well tolerated by young people. By identifying important functional regions within the brain, including unpredictable patterns of functional reorganization, it can aid in surgical decision-making. Here we illustrate this using a number of case studies from the pediatric epilepsy surgery program at our institution. We describe how fMRI, used in conjunction with conventional investigative methods such as neuropsychological assessment, MRI, and electrophysiology, can 1) help to improve functional outcome by enabling resective surgery that spares functional cortex, 2) guide surgical intervention by revealing when reorganization of function has occurred, and 3) show when abnormal cortex is also functionally active, and hence that surgery may not be the best option. Altogether, these roles have reduced the need for invasive procedures that can be both risky and distressing for young people with epilepsy. In our experience, fMRI has significantly contributed to the decision-making process, and improved the counseling and management of youn...Continue Reading

References

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Feb 15, 2005·Clinical Neurology and Neurosurgery·Rupert LanzenbergerRoland Beisteiner

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Citations

Nov 26, 2009·Pediatric Radiology·James L Leach, Scott K Holland
Jun 3, 2011·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Nicole M GageShirley M Otis
Jan 1, 2009·Acta chirurgica Iugoslavica·O B SveljoZ Kojadinović
May 4, 2010·Journal of Neurosurgery. Pediatrics·Hillary ShurtleffJeffrey G Ojemann
Sep 8, 2012·Epilepsy Research and Treatment·Sandrine de RibaupierreSusan Hayman-Abello
Apr 29, 2008·Neuro-Chirurgie·C Chiron, L Hertz-Pannier
Jan 1, 2013·Brain Topography·Mathieu BourguignonXavier De Tiège
Dec 3, 2014·Neuroimaging Clinics of North America·Lucie Hertz-PannierCatherine Chiron
May 2, 2006·Journal of Magnetic Resonance Imaging : JMRI·Peter Jezzard, Richard B Buxton
Feb 9, 2010·Journal of Child Neurology·Brandon KormanGustavo Rey
May 29, 2018·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Anna LorenzenMartin U Schuhmann
Nov 28, 2018·Annals of Clinical and Translational Neurology·Marko WilkeIngeborg Krägeloh-Mann
Apr 26, 2020·Seminars in Pediatric Neurology·Julie B GuerinJames L Leach
Jul 28, 2018·The Indian Journal of Radiology & Imaging·Ruma M SreedharanSanjeev V Thomas
Nov 9, 2011·Seminars in Pediatric Neurology·M Scott Perry, Michael Duchowny

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