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 INVITED REVIEW
Year : 2008  |  Volume : 3  |  Issue : 1  |  Page : 74-81

Presurgical evaluation of epilepsy


1 Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India
2 Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India

Correspondence Address:
Manas Panigrahi
Dept. of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.40593

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The objective of the multimodality presurgical evaluation in patients with refractory epilepsy is to establish sufficient concordance among the various investigations. There should be maximum overlap in the epileptogenic zone, the irritative zone, the ictal onset zone, the functional deficit zone and the symptomatogenic zone. The ictal and interictal electroencephalogram measures the localization of epileptiform discharges, which should be concordant with structural abnormalities noted on MRI brain and functional abnormalities in the form of a zone of hypometabolism on fluorodeoxyglucose positron emission tomography, interictal single photon emission computerized tomography (SPECT) or hyperperfusion of the epileptogenic zone on ictal SPECT for a good surgical outcome. There should be no conflicting data from any of these studies, neuropsychological evaluation or seizure semiology.






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