Frontal Lobe Epilepsy - Importance of Neuroimaging

Importance of Neuroimaging

Once anticonvulsant medications prove to be no longer effective and a patient is selected to undergo resective epilepsy surgery, the doctors must begin the surgical process by first identifying the epileptogenic zone. The removal of the epileptogenic zone, the area of brain tissue that is responsible for the generation of seizures, can lead to a reduction or freedom in the amount of seizures. One of the major concerns for surgeons before they operate on patients that have intractable epilepsis is to not only be able to pinpoint the epileptogenic zone that is to be removed but to also map out the localized regions surrounding the focal area that are associated with somatosensory, cognitive and motor functions. Through the use of neuroimaging devices such as fMRIs, PET scans and SPECT scans doctors are now able to identify the exact positions of the lesions causing the seizures and can map out the sensorimotor, language, visual and memory functional locations in the frontal lobes of the brain prior to the resective surgery. Therefore structural and functional neuroimaging techniques help to fulfill two major goals: localiztion of the epileptogenic zone and the determination of the etiology producing the seizure. Prior to the invention of neuroimaging techniques, surgeries to eliminate frontal lobe seizures from occurring were very rare and not very successful. However the ability to localize the epiletogenic zone and the specific etiology for the seizures has made frontal lobe resective surgery just as successful as that for temporal lobe resective surgery.