Cascino Gregory D
Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Semin Neurol. 2008 Sep;28(4):523-32. doi: 10.1055/s-0028-1083687. Epub 2008 Oct 8.
The diagnostic evaluation of the patient with partial or localization-related epilepsy is designed to identify treatment strategies that will permit the individual to be seizure-free. The use of magnetic resonance imaging (MRI) has been pivotal in elucidating the presence of an epileptogenic pathological alteration that may coexist with the site of seizure onset. There are compelling data that MRI is of significant diagnostic and prognostic importance in patients with partial epilepsy. Patients with MRI-negative partial epilepsy may be candidates for additional neuroimaging techniques including positron emission tomography, MR spectroscopy, and single photon emission tomography. Contemporary innovations with peri-ictal imaging may allow identification of the epileptogenic zone in patients with normal MRI scans. This discussion will focus on the management of the adult patient with seizures and epilepsy, emphasizing the neuroimaging evaluation and treatment of patients with medically refractory seizure disorders.
对部分性或局灶性相关性癫痫患者的诊断评估旨在确定能使个体无癫痫发作的治疗策略。磁共振成像（MRI）的应用对于阐明可能与癫痫发作起始部位共存的致痫性病理改变至关重要。有确凿数据表明，MRI在部分性癫痫患者中具有重要的诊断和预后意义。MRI检查结果为阴性的部分性癫痫患者可能适合采用包括正电子发射断层扫描、磁共振波谱分析和单光子发射断层扫描在内的其他神经影像学技术。发作期成像的当代创新技术可能有助于在MRI扫描正常的患者中识别致痫区。本讨论将聚焦于成年癫痫发作患者的管理，重点是对药物难治性癫痫障碍患者的神经影像学评估和治疗。
