Advances in Structural and Functional Neuroimaging: How Are These Guiding Epilepsy Surgery?

Epilepsy surgery has been revolutionized by modern neuroimaging. Prior to the advent of CT and early MR imaging, the task of localizing seizures was, for the most part, a needlein-the-haystack search based on electrophysiologic localization methods with recording electrodes typically requiring placement in or directly on the brain. Even with tomographic imaging that became widely available in the late 1970s and early 1980s, the majority of pathologic lesions serving as epileptogenic substrates or pathology remained undetected (cryptogenic).