Structural and quantitative mri in epilepsy

Magnetic resonance imaging (MRI) is a critical component of the basic clinical assessment of epilepsy. Detection of abnormalities on MRI is essential to establishing an initial diagnosis (idiopathic, cryptogenic, or symptomatic) and determining options for treatment. MRI studies are especially critical in focal epilepsy, as resective surgery of an epileptogenic lesion has the potential to render many patients seizure-free (Engel, 1996; Wiebe, Blume, Girvin, and Eliasziw, 2001). Improvements in high-resolution MRI and quantitative post-processing methods now permit detection of structural abnormalities in patients that are not otherwise visually apparent. This is especially important as an MRI-identified lesion is associated both with poorer response to medications (Cardoso et al., 2006; Spooner, Berkovic, Mitchell, Wrennall, and Harvey, 2006) and with a greater likelihood of seizure freedom following resective surgery (Berkovic et al., 1995; Jeha et al.,