Neuroradiologische Diagnostik in der Epileptologie

F. G. Woermann; C. Brandt; R. Schaumann-von-Stosch

doi:10.1055/s-2003-814848

Aktuelle Neurologie, Table of Contents

Aktuelle Neurologie 2004; 31(2): 60-72
DOI: 10.1055/s-2003-814848

Übersicht

Neuroradiologische Diagnostik in der Epileptologie

Clinical Neuroimaging in EpilepsyF. G. Woermann¹ , C. Brandt¹ , R. Schaumann-von-Stosch²

¹Epilepsiezentrum Bethel (Chefarzt: Prof. Dr. B. Pohlmann-Eden), Bielefeld
²Schweizerisches Epilepsie-Zentrum (Medizinischer Direktor: Dr. G. Krämer), Zürich

Abstract

Zusammenfassung

Die Magnetresonanztomographie (MRT) ist die neuroradiologische Methode der ersten Wahl bei Epilepsie. Ein MR-Untersuchungsprotokoll, das koronare, an der Hippokampuslängsachse angulierte FLAIR- und T₂-Sequenzen enthält, erhöht die Chance, eine morphologische Läsion bei dieser chronischen Erkrankung zu identifizieren. Eine anfallsverursachende Läsion kann die medikamentöse Epilepsiebehandlung erschweren. Ihr Nachweis ermöglicht andererseits aber die chirurgische Behandlung. Die präoperative Abgrenzung eloquenter Kortexareale von dieser Läsion erlaubt die Abschätzung postoperativer Morbidität. Diese Übersicht befasst sich mit dem Beitrag, den verschiedene Bildgebungsmethoden zur Beantwortung dieser klinischen Fragen nach anfallsverursachenden Läsionen und benachbarter neuronaler Funktion leisten (visuell beurteilte MRT, quantitative strukturelle und funktionelle MR-Verfahren sowie nuklearmedizinische Methoden). Die Bearbeitung aktueller wissenschaftlicher Fragen in der klinischen Epileptologie (zur Optimierung der bildgebenden Verfahren, zu Ursachen und Konsequenzen von epileptischen Anfällen, zur Pharmakoresistenz) mittels dieser Methoden wird diskutiert.

Abstract

Magnetic resonance imaging is the neuroimaging modality of first choice in epilepsy. A protocol incorporating coronal FLAIR- and T₂-weighted images perpendicular to the long axis of the hippocampus increases the yield to detect epilepsy-associated lesions. The presence of an epileptogenic lesion decreases the probability to render the patient seizure free by anti-epileptic drugs only. The detection of a lesion, however, is a prerequisite for epilepsy surgery. To avoid postsurgical morbidity, identification of eloquent cortex in relation to the epileptogenic lesion is necessary prior to surgery. This review describes the clinical impact of different neuroimaging modalities on lesion detection and on the delineation of adjacent neuronal function (qualitative and quantitative structural and functional MR methods, methods using radioactive nuclids). Recent contributions of neuroimaging research to current topics in the field (increasing sensitivity of neuroimaging, differentiating causes from consequences of seizures, defining medical untreatability) are discussed.

Full Text

References

Literatur

1 Neuroimaging Commission of ILAE . Recommendations for neuroimaging of patients with epilepsy. Epilepsia. 1997; 38, Suppl 10 1-2
2 Wright N B. Imaging in epilepsy: a pediatric perspective. The British Journal of Radiology. 2001; 74 575-580
3 Bronen R A, Fulbright R K, Kim J H. et al . A systematic approach for interpreting MR images of the seizure patient. Am J Radiol AJR. 1997; 169 241-247
4 Kuzniecky R I, Jackson G D. Magnetic Resonance in Epilepsy. New York; Raven Press 1994: 43
5 Semah F, Picot M C, Adam C. et al . Is the underlying cause of epilepsy a major prognostic factor for recurrence?. Neurology. 1998; 51 1256-1262
6 Rosenow F, Luders H. Presurgical evaluation of epilepsy. Brain. 2001; 124 1683-1700
7 Hagemann G, Krakow K, Woermann F G. Funktionelle MR-Verfahren in der Epilepsiediagnostik. Klin Neurophysiol. 2000; 31 (s1) S49-56
8 Woermann F G, Mertens M, Kruse B. et al . Funktionelle Magnetresonanztomographie: Grundlagen und Anwendungen bei Kindern mit Epilepsie. Neuropädiatrie. 2003; 2 44-50
9 ILAE Commission on Diagnostic Strategies . Recommendations for functional neuroimaging of persons with epilepsy. Epilepsia. 2000; 41 1350-1356
10 Spencer S S, Bautista R E. Functional neuroimaging in localization of the ictal onset zone. Adv Neurol. 2000; 83 285-296
11 Duncan J S. Neuroimaging methods to evaluate the etiology and consequences of epilepsy. Epilepsy Res. 2002; 50 131-140
12 Veith G. Anatomische Studie über die Ammonshornsklerose im Epileptikergehirn. Dtsch Z Nervenheilk. 1970; 197 293-314
13 Veith G. Der angeborene Hirnschaden - anatomische Grundlagen. Mschr Kinderheilk. 1973; 121 252-259
14 Lahl R, Villagran R, Teixeira W. Neuropathology of Focal Epilepsies: An Atlas. London; John Libbey 2003
15 Li L M, Fish D R, Sisodiya S M. et al . High resolution magnetic resonance imaging in adults with partial or secondary generalised epilepsy attending a tertiary referral unit. J Neurol Neurosurg Psychiatry. 1995; 59 384-387
16 King M A, Newton M R, Jackson G D. et al . Epileptology of the first-seizure presentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet. 1998; 352 1007-1011
17 Wieshmann U C. Clinical application of neuroimaging in epilepsy. J Neurol Neurosurg Psychiatry. 2003; 74 466-470
18 Engel J. Introduction to temporal lobe epilepsy. Epilepsy Res. 1996; 26 141-150
19 Jackson G D, Berkovic S F, Tress B M. et al . Hippocampal sclerosis can be reliably detected by magnetic resonance imaging. Neurology. 1990; 40 1869-1875
20 Ostertun B. Radiologische Diagnostik bei Epilepsie. Röfo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1999; 170 235-245
21 Bronen R A, Gupta V. Epilepsy. In: Atlas SW (ed) Magnetic Resonance Imaging of the Brain and Spine. Philadelphia; Lippincott, Williams and Wilkins 2002: 415-455
22 Stevens J M. Neuroradiology in epilepsy. In: Scaravilli F (ed) Neuropathology of Epilepsy. Singapore; World Scientific 1998: 77-139
23 Kim J H, Tien R D, Felsberg G J. et al . Clinical significance of asymmetry of the fornix and mamillary body on MR in hippocampal sclerosis. AJNR Am J Neuroradiol. 1995; 16 509-515
24 Meiners L C, Witkamp T D, Kort G A de. et al . Relevance of temporal lobe white matter changes in hippocampal sclerosis. Magnetic resonance imaging and histology. Invest Radiol. 1999; 34 38-45
25 Wiebe S, Blume W T, Girvin J P. et al . Effectiveness and efficiency of surgery for temporal lobe epilepsy study group. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001; 345 311-318
26 Radhakrishnan K, So E L, Silbert P L. et al . Predictors of outcome of anterior temporal lobectomy for intractable epilepsy: a multivariate study. Neurology. 1998; 51 465-471
27 Yoon H H, Kwon H L, Mattson R H. et al . Long-term seizure outcome in patients initially seizure-free after resective epilepsy surgery. Neurology. 2003; 61 445-450
28 Kuzniecky R, Burgard S, Faught E. et al . Predictive value of magnetic resonance imaging in temporal lobe epilepsy surgery. Arch Neurol. 1993; 50 65-69
29 Bronen R A, Fulbright R K, King D. et al . Qualitative MR imaging of refractory temporal lobe epilepsy requiring surgery: correlation with pathology and seizure outcome after surgery. AJR Am J Roentgenol. 1997; 169 875-882
30 Berkovic S F, McIntosh A M, Kalnins R M. et al . Preoperative MRI predicts outcome of temporal lobectomy: an actuarial analysis. Neurology. 1995; 45 1358-1363
31 Cendes F, Cook M J, Watson C. et al . Frequency and characteristics of dual pathology in patients with lesional epilepsy. Neurology. 1995; 45 2058-2064
32 Kleihues P, Cavenee W K. WHO Classification of Tumours - Pathology + Genetics - Tumours of the Nervous System. Lyon; IARC Press 2000: 95ff
33 Zentner J, Hufnagel A, Wolf H K. et al . Surgical treatment of temporal lobe epilepsy: clinical, radiological, and histopathological findings in 178 patients. J Neurol Neurosurg Psychiatry. 1995; 58 666-673
34 Zentner J, Hufnagel A, Ostertun B. et al . Surgical treatment of extratemporal epilepsy: clinical, radiologic, and histopathologic findings in 60 patients. Epilepsia. 1996; 37 1072-1080
35 Ostertun B, Wolf H K, Campos M G. et al . Dysembryoplastic neuroepithelial tumors: MR and CT evaluation. AJNR Am J Neuroradiol. 1996; 17 419-430
36 Daumas-Duport C, Varlet P, Bacha S. et al . Dysembryoplastic neuroepithelial tumors: nonspecific histological forms - a study of 40 cases. J Neurooncol. 1999; 41 267-280
37 Prayson R A, Estes M L, Morris H H. Coexistence of neoplasia and cortical dysplasia in patients presenting with seizures. Epilepsia. 1993; 34 609-615
38 Barkovich A J, Kuzniecky R I, Jackson G D. et al . Classification system for malformations of cortical development: update 2001. Neurology. 2001; 57 2168-2178
39 Barkovich A J. Pediatric Neuroimaging. Philadelphia; Lippincott, Williams + Wilkins 2000: 251ff
40 Hagemann G, Redecker C, Witte O W. Kortikale Dysgenesien - aktuelle Klassifikation, kernspintomographische Diagnostik und klinische Übersicht. Nervenarzt. 2000; 71 616-628
41 Kloss S, Pieper T, Pannek H. et al . Epilepsy surgery in children with focal cortical dysplasia (FCD): results of long-term seizure outcome. Neuropediatrics. 2002; 33 21-26
42 Urbach H, Scheffler B, Heinrichsmeier T. et al . Focal cortical dysplasia of Taylor's balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome. Epilepsia. 2002; 43 33-40
43 Tassi L, Colombo N, Garbelli R. et al . Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain. 2002; 125 1719-1732
44 Edwards J C, Wyllie E, Ruggeri P M. et al . Seizure outcome after surgery for epilepsy due to malformation of cortical development. Neurology. 2000; 55 1110-1114
45 Sisodiya S M, Free S L, Stevens J M. et al . Widespread cerebral structural changes in patients with cortical dysgenesis and epilepsy. Brain. 1995; 118 1039-1050
46 Sisodiya S M, Moran N, Free S L. et al . Correlation of widespread preoperative magnetic resonance imaging changes with unsuccessful surgery for hippocampal sclerosis. Ann Neurol. 1997; 41 490-496
47 Karenfort M, Kruse B, Freitag H. et al . Epilepsy surgery outcome in children with focal epilepsy due to tuberous sclerosis complex. Neuropediatrics. 2002; 33 255-261
48 Chugani D C, Chugani H T, Muzik O. et al . Imaging epileptogenic tubers in children with tuberous sclerosis complex using alpha-[11C]methyl-L-tryptophan positron emission tomography. Ann Neurol. 1998; 44 858-866
49 Marusic P, Najm I M, Ying Z. et al . Focal cortical dysplasias in eloquent cortex: functional characteristics and correlation with MRI and histopathologic changes. Epilepsia. 2002; 43 27-32
50 Janszky J, Ebner A, Kruse B. et al . Functional organization of the brain with malformations of cortical development. Ann Neurol. 2003; 53 759-767
51 Barkovich A J. Abnormal vascular drainage in anomalies of neuronal migration. AJNR Am J Neuroradiol. 1988; 9 939-942
52 Bronen R A, Knowlton R, Garwood M. et al . High resolution imaging in epilepsy. Epilepsia. 2002; 43, Suppl 1 11-18
53 Wyllie E. Catastrophic epilepsy in infants and children: identification of surgical candidates. Epileptic Disord. 1999; 1 261-264
54 Bien C G, Widman G, Urbach H. et al . The natural history of Rasmussen's encephalitis. Brain. 2002; 125 1751-1759
55 Devlin A M, Cross J H, Harkness W. et al . Clinical outcomes of hemispherectomy for epilepsy in childhood and adolescence. Brain. 2003; 126 556-566
56 Palmini A, Chandler C, Andermann F. et al . Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology. 2002; 58 1338-1347
57 Wieshmann U C, Free S L, Everitt A D. et al . Magnetic resonance imaging in epilepsy with a fast FLAIR sequence. J Neurol Neurosurg Psychiatry. 1996; 61 357-361
58 Serles W, Baumgartner C, Feichtinger M. et al .Richtlinien für ein standardisiertes MRT-Protokoll für Patienten mit epileptischen Anfällen in Österreich. Mitteilungen der österreichischen Sektion der ILAE. 2003 1: 2-13, http://www.medicalnet.at/oe.sektion-ILAE/ilae103.pdf
59 Tuxhorn I. et al . Empfehlungen zur Bildgebung bei Patienten mit Epilepsie. Epilepsieblätter. 2000; 13 92-94
60 Ostertun B. Diagnostik bei Epilepsien. In: Sartor K (Hrsg) Neuroradiologie. Stuttgart; Thieme 2001: 66-69
61 Oertzen J von, Urbach H, Jungbluth S. et al . Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy. J Neurol Neurosurg Psychiatry. 2002; 73 643-647
62 Kretschmann H J, Weinrich W. Klinische Neuroanatomie und kranielle Bilddiagnostik - Atlas der Magnetresonanztomographie und Computertomographie. Stuttgart; Thieme 2003
63 Duvernoy H M. The Human Hippocampus - Functional Anatomy, Vascularization and serial Sections with MRI. Berlin; Springer 1998
64 Tamraz J C, Comair Y G. Atlas of Regional Anatomy of the Brain Using MRI - With Functional Correlations. Berlin; Springer 2000
65 Duncan J S. Imaging and epilepsy. Brain. 1997; 120 339-377
66 Paesschen W Van. Quantitative MRI of mesial temporal structures in temporal lobe epilepsy. Epilepsia. 1997; 38, Suppl 10 3-12
67 Bastos A, Bernasconi A, Bernasconi N. et al . Structural image analysis in epilepsy. Epilepsia. 2002; 43, Suppl 1 19-24
68 Ashburner J, Friston K J. Voxel-based morphometry - the methods. Neuroimage. 2000; 11 805-821
69 Materka A, Strzelecki M. Texture Analysis Methods - A Review. Lodz; 1998, http://www.eletel.p.lodz.pl
70 Jack C R, Sharbrough F W, Twomey C K. et al . Temporal lobe seizures: lateralization with MR volume measurements of the hippocampal formation. Radiology. 1990; 175 423-429
71 Jack C R, Sharbrough F W, Cascino G D. et al . Magnetic resonance image-based hippocampal volumetry: correlation with outcome after temporal lobectomy. Ann Neurol. 1992; 31 138-146
72 Moran N F, Lemieux L, Kitchen N D. et al . Extrahippocampal temporal lobe atrophy in temporal lobe epilepsy and mesial temporal sclerosis. Brain. 2001; 124 167-175
73 Jackson G D, Connelly A, Duncan J S. et al . Detection of hippocampal pathology in intractable partial epilepsy: increased sensitivity with quantitative magnetic resonance T₂ relaxometry. Neurology. 1993; 43 1793-1799
74 Paesschen W Van, Sisodiya S, Connelly A. et al . Quantitative hippocampal MRI and intractable temporal lobe epilepsy. Neurology. 1995; 45 2233-2240
75 Woermann F G, Free S L, Koepp M J. et al . Voxel-by-voxel comparison of automatically segmented cerebral gray matter - A rater-independent comparison of structural MRI in patients with epilepsy. Neuroimage. 1999; 10 373-384
76 Kassubek J, Huppertz H J, Spreer J. et al . Detection and localization of focal cortical dysplasia by voxel-based 3-D MRI analysis. Epilepsia. 2002; 43 596-602
77 Bernasconi A, Antel S B, Collins D L. et al . Texture analysis and morphological processing of magnetic resonance imaging assist detection of focal cortical dysplasia in extra-temporal partial epilepsy. Ann Neurol. 2001; 49 770-775
78 Spencer S S, McCarthy G, Spencer D D. Diagnosis of medial temporal lobe seizure onset: relative specificity and sensitivity of quantitative MRI. Neurology. 1993; 43 2117-2124
79 Bernasconi A, Bernasconi N, Caramanos Z. et al . T₂ relaxometry can lateralize mesial temporal lobe epilepsy in patients with normal MRI. Neuroimage. 2000; 12 739-746
80 Kent D L, Haynor D R, Longstreth W T. et al . The clinical efficacy of magnetic resonance imaging in neuroimaging. Ann Intern Med. 1994; 120 856-871
81 Knowlton R C, Laxer K D, Ende G. et al . Presurgical multimodality neuroimaging in electroencephalographic lateralized temporal lobe epilepsy. Ann Neurol. 1997; 42 829-837
82 Antel S B, Li L M, Cendes F. et al . Predicting surgical outcome in temporal lobe epilepsy patients using MRI and MRSI. Neurology. 2002; 58 1505-1512
83 Winkler P A, Herzog C, Henkel A. et al . Nicht-invasives Protokoll für die epilepsiechirurgische Behandlung fokaler Epilepsien. Nervenarzt. 1999; 70 1088-1093
84 Helmstaedter C, Kurthen M, Lux S. et al . Temporallappenepilepsie - längsschnittliche klinische, neuropsychologische und psychosoziale Entwicklung operativ und konservativ behandelter Patienten. Nervenarzt. 2000; 71 629-642
85 Jokeit H, Ebner A. Effects of chronic epilepsy on intellectual functions. Prog Brain Res. 2002; 135 455-463
86 Sutula T, Pitkänen A. Do Seizures Damage the Brain? (Progress in Brain Research). Amsterdam; Elsevier 2002
87 Wieshmann U C, Woermann F G, Lemieux L. et al . Development of hippocampal atrophy: a serial magnetic resonance imaging study in a patient who developed epilepsy after generalized status epilepticus. Epilepsia. 1997; 38 1238-1241
88 Salmenpera T, Kalviainen R, Partanen K. et al . MRI volumetry of the hippocampus, amygdala, entorhinal cortex, and perirhinal cortex after status epilepticus. Epilepsy Res. 2000; 40 155-170
89 Jackson G, Paesschen W Van. Hippocampal sclerosis in the MR era. Epilepsia. 2002; 43, Suppl 1 4-10
90 Scott R C, King M D, Gadian D G. et al . Hippocampal Abnormalities after Prolonged Febrile Convulsion: A Longitudinal MRI Study. Brain. 2003; 126 2551-2557
91 Fernandez G, Effenberger O, Vinz B. et al . Hippocampal malformation as a cause of familial febrile convulsions and subsequent hippocampal sclerosis. Neurology. 1998; 50 909-917
92 Liu R S, Lemieux L, Bell G S. et al . Progressive neocortical damage in epilepsy. Ann Neurol. 2003; 53 312-324
93 Baxendale S A, Thompson P J, Kitchen N D. Postoperative hippocampal remnant shrinkage and memory decline: a dynamic process. Neurology. 2000; 55 243-249
94 Clusmann H, Schramm J, Kral T. et al . Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. J Neurosurg. 2002; 97 1131-1141
95 Moran N F, Lemieux L, Maudgil D. et al . Analysis of temporal lobe resections in MR images. Epilepsia. 1999; 40 1077-1084
96 Schwartz T H, Spencer D D. Strategies for reoperation after comprehensive epilepsy surgery. J Neurosurg. 2001; 95 615-623
97 Elst L T Van, Woermann F G, Lemieux L. et al . Affective aggression in patients with temporal lobe epilepsy: a quantitative MRI study of the amygdala. Brain. 2000; 123 234-243
98 Trimble M R, Elst L T Van. The amygdala and psychopathology studies in epilepsy. Ann N Y Acad Sci. 2003; 985 461-468
99 Woermann F G, Elst L T Van, Koepp M J. et al . Reduction of frontal neocortical grey matter associated with affective aggression in patients with temporal lobe epilepsy: an objective voxel by voxel analysis of automatically segmented MRI. J Neurol Neurosurg Psychiatry. 2000; 68 162-169
100 Koch-Stoecker S. Personality disorders as predictors of severe postsurgical psychiatric complications in epilepsy patients undergoing temporal lobe resections. Epilepsy Behav. 2002; 3 526-531
101 Raab P, Pilatus U, Lanfermann H, Zanella F E. Grundlagen und klinische Anwendung der MR-Spektroskopie des Gehirns. Akt Neurol. 2002; 29 53-62
102 Hetherington H P, Gadian D G, Ng T C. Magnetic resonance spectroscopy in epilepsy: technical issues. Epilepsia. 2002; 43, Suppl 1 25-31
103 Cendes F, Knowlton R C, Novotny E. et al . Magnetic resonance spectroscopy in epilepsy: clinical issues. Epilepsia. 2002; 43, Suppl 1 32-39
104 Hugg J W, Laxer K D, Matson G B. et al . Neuron loss localizes human temporal lobe epilepsy by in vivo proton magnetic resonance spectroscopic imaging. Ann Neurol. 1993; 34 788-794
105 Connelly A, Paesschen W Van, Porter D A. et al . Proton magnetic resonance spectroscopy in MRI-negative temporal lobe epilepsy. Neurology. 1998; 51 61-66
106 Woermann F G, McLean M A, Bartlett P A. et al . Short echo time single-voxel 1H magnetic resonance spectroscopy in magnetic resonance imaging-negative temporal lobe epilepsy: different biochemical profile compared with hippocampal sclerosis. Ann Neurol. 1999; 45 369-376
107 Li L M, Cendes F, Antel S B. et al . Prognostic value of proton magnetic resonance spectroscopic imaging for surgical outcome in patients with intractable temporal lobe epilepsy and bilateral hippocampal atrophy. Ann Neurol. 2000; 47 195-200
108 Stefan H, Pauli E, Eberhardt K E. et al . MR-Spektroskopie und T₂-Relaxometrie bei kryptogener Temporallappenepilepsie und postoperativer Prognose. Nervenarzt. 2000; 71 282-287
109 Stefan H, Eberhardt K E, Pauli E. et al . Bildgebende Verfahren bei pharmakoresistenter Temporallappenepilepsie. Vergleich von MR-Volumetrie und Multivoxel-MR-Spektroskopie zur Einschätzung der postoperativen Prognose. Nervenarzt. 2001; 72 130-135
110 Schulz R, Luders H O, Hoppe M. et al . Interictal EEG and ictal scalp EEG propagation are highly predictive of surgical outcome in mesial temporal lobe epilepsy. Epilepsia. 2000; 41 564-570
111 Cendes F, Andermann F, Dubeau F. et al . Normalization of neuronal metabolic dysfunction after surgery for temporal lobe epilepsy. Evidence from proton MR spectroscopic imaging. Neurology. 1997; 49 1525-1533
112 Suhy J, Laxer K D, Capizzano A A. et al . 1H MRSI predicts surgical outcome in MRI-negative temporal lobe epilepsy. Neurology. 2002; 58 821-823
113 Woermann F G, McLean M A, Bartlett P A. et al . Quantitative short echo time proton magnetic resonance spectroscopic imaging study of malformations of cortical development causing epilepsy. Brain. 2001; 124 427-436
114 Petroff O AC, Pan J W, Rothman D L. Magnetic resonance spectroscopic studies of neurotransmitters and energy metabolism in epilepsy. Epilepsia. 2002; 43, Suppl 1 40-50
115 Petroff O AC, Mattson R H, Behar K L. et al . Vigabatrin increases human brain homocarnosine and improves seizure control. Ann Neurol. 1998; 44 948-952
116 Hammeke T A, Bellgowan P S, Binder J R. FMRI: methodology - cognitive function mapping. Adv Neurol. 2000; 83 221-233
117 Binder J R, Achten E, Constable R T. et al . Functional MRI in epilepsy. Epilepsia. 2002; 43, Suppl 1 51-63
118 Woermann F G, Jokeit H, Luerding R. et al . Language lateralization by Wada test and fMRI in 100 patients with epilepsy. Neurology. 2003; 61 699-701
119 Hertz-Pannier L, Chiron C, Jambaque I. et al . Late plasticity for language in a child's non-dominant hemisphere: a pre- and post-surgery fMRI study. Brain. 2002; 125 361-372
120 Lehericy S, Cohen L, Bazin B. et al . Functional MR evaluation of temporal and frontal language dominance compared with the Wada test. Neurology. 2000; 54 1625-1633
121 Detre J A, Maccotta L, King D. et al . Functional MRI lateralization of memory in temporal lobe epilepsy. Neurology. 1998; 50 926-932
122 Bellgowan P S, Binder J R, Swanson S J. et al . Side of seizure focus predicts left medial temporal lobe activation during verbal encoding. Neurology. 1998; 51 479-484
123 Jokeit H, Okujava M, Woermann F G. Memory fMRI lateralizes temporal lobe epilepsy. Neurology. 2001; 57 1786-1793
124 Jack C R, Lee C C, Ward H A. et al . The role of functional MRI in planning perirolandic surgery. In: Moonen CTW, Bandettini PA (eds) Functional MRI. Berlin; Springer 1999: 539-550
125 Jackson G D, Connelly A, Cross J H. et al . Functional magnetic resonance imaging of focal seizures. Neurology. 1994; 44 850-856
126 Detre J A, Sirven J I, Alsop D C. et al . Localization of subclinical ictal activity by functional magnetic resonance imaging: correlation with invasive monitoring. Ann Neurol. 1995; 38 618-624
127 Lemieux L, Salek-Haddadi A, Hoffmann A. et al . EEG-correlated functional MRI: recent methodologic progress and current issues. Epilepsia. 2002; 43, Suppl 1 64-68
128 Salek-Haddadi A, Lemieux L, Merschhemke M. et al . Functional magnetic resonance imaging of human absence seizures. Ann Neurol. 2003; 53 663-667
129 Wieshmann U C, Symms M R, Shorvon S D. Diffusion changes in status epilepticus. Lancet. 1997; 350 493-494
130 Diehl B, Najm I, Ruggieri P. et al . Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy. Epilepsia. 2001; 42 21-28
131 Hufnagel A, Weber J, Marks S. et al . Brain diffusion after single seizures. Epilepsia. 2003; 44 54-63
132 Niendorf T. Methodische Grundlagen moderner Magnet-Resonanz-Bildgebungsverfahren und ihre Anwendung in der Neurologie. Klin Neurophysiol. 2000; 31, S 1 2-17
133 Bradley W G, Shey R B. MR imaging evaluation of seizures. Radiology. 2000; 214 651-656
134 Lux H D, Heinemann U, Dietzel I. Ionic changes and alterations in the size of the extracellular space during epileptic activity. Adv Neurol. 1986; 44 619-639
135 Wolf R L, Alsop D C, Levy-Reis I. et al . Detection of mesial temporal lobe hypoperfusion in patients with temporal lobe epilepsy by use of arterial spin labeled perfusion MR imaging. AJNR Am J Neuroradiol. 2001; 22 1334-1341
136 Warach S, Levin J M, Schomer D L. et al . Hyperperfusion of ictal seizure focus demonstrated by MR perfusion imaging. AJNR Am J Neuroradiol. 1994; 15 965-968
137 Neuroimaging Commission of ILAE . Recommendations for functional neuroimaging of persons with epilepsy. Epilepsia. 2000; 41 1350-1356
138 Kuwert T, Bartenstein P, Grunwald F. et al . Klinische Wertigkeit der Positronen-Emissions-Tomographie in der Neuromedizin - Positionspapier zu den Ergebnissen einer interdisziplinären Konsensuskonferenz. Nervenarzt. 1998; 69 1045-1060
139 Bartenstein P. Rezeptordarstellung mit der Positronen-Emissions-Tomographie - Anwendung in Klinik und Forschung. Akt Neurol. 2002; 29 1-11
140 Juengling F D, Kassubek J. Nuklearmedizinische Bildgebung in der Epilepsiediagnostik. Teil I: Perfusion und Metabolismus. Nervenheilkunde. 2002; 21 420-425
141 Kassubek J, Juengling F D. Nuklearmedizinische Bildgebung in der Epilepsiediagnostik. Teil II: Rezeptordiagnostik und funktionelle Bildgebung. Nervenheilkunde. 2002; 21 475-481
142 Koepp M J, Hammers A, Labbe C. et al . 11C-flumazenil PET in patients with refractory temporal lobe epilepsy and normal MRI. Neurology. 2000; 54 332-339
143 Hammers A, Koepp M J, Richardson M P. et al . Grey and white matter flumazenil binding in neocortical epilepsy with normal MRI. A PET study of 44 patients. Brain. 2003; 126 1300-1318
144 Kim S K, Na D G, Byun H S. et al . Focal cortical dysplasia: comparison of MRI and FDG-PET. J Comput Assist Tomogr. 2000; 24 296-302
145 Hwang S I, Kim J H, Park S W. et al . Comparative analysis of MR imaging, positron emission tomography, and ictal single-photon emission CT in patients with neocortical epilepsy. AJNR Am J Neuroradiol. 2001; 22 937-946
146 Frost J J, Mayberg H S, Fisher R S. et al . Mu-opiate receptors measured by positron emission tomography are increased in temporal lobe epilepsy. Ann Neurol. 1988; 23 231-237
147 Schlösser R. Erfassung von Neurotransmitterinteraktionen mit PET und SPECT durch pharmakologische Challenge-Paradigmen. Nervenarzt. 2000; 71 9-18
148 Bartenstein P A, Duncan J S, Prevett M C. et al . Investigation of the opioid system in absence seizures with positron emission tomography. J Neurol Neurosurg Psychiatry. 1993; 56 1295-1302
149 Koepp M J, Richardson M P, Brooks D J. et al . Focal cortical release of endogenous opioids during reading-induced seizures. Lancet. 1998; 352 952-955
150 Sostman H D, Spencer D D, Gore J C. et al . Preliminary observations on magnetic resonance imaging in refractory epilepsy. Magn Reson Imaging. 1984; 2 301-306

Dr. F. G. Woermann

MRT-Abteilung · Krankenhaus Mara

Maraweg 21

33617 Bielefeld

Email: fgw@mara.de