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Journal of Pediatric Epilepsy 2023; 12(01): 009-020
DOI: 10.1055/s-0042-1760104
Review Article

The Noninvasive Evaluation for Minimally Invasive Pediatric Epilepsy Surgery (MIPES): A Multimodal Exploration of the Localization-Based Hypothesis

Deepankar Mohanty
1   Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
,
Michael Quach
1   Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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Abstract

Minimally invasive pediatric epilepsy surgery (MIPES) is a rising technique in the management of focal-onset drug-refractory epilepsy. Minimally invasive surgical techniques are based on small, focal interventions (such as parenchymal ablation or localized neuromodulation) leading to elimination of the seizure onset zone or interruption of the larger epileptic network. Precise localization of the seizure onset zone, demarcation of eloquent cortex, and mapping of the network leading to seizure propagation are required to achieve optimal outcomes. The toolbox for presurgical, noninvasive evaluation of focal epilepsy continues to expand rapidly, with a variety of options based on advanced imaging and electrophysiology. In this article, we will examine several of these diagnostic modalities from the standpoint of MIPES and discuss how each can contribute to the development of a localization-based hypothesis for potential surgical targets.

Keywords

pediatric epilepsy surgery - electroencephalography - magnetoencephalography - source localization - MRI


Publication History

Received: 15 November 2022

Accepted: 15 November 2022

Article published online:
22 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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