Epileptic Disorders


MRI essentials in epileptology: a review from the ILAE Imaging Taskforce Volume 22, issue 4, August 2020


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1 Epilepsy Center, Cleveland Clinic, Cleveland, USA
2 Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre and Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
3 Multimodal Imaging and Connectome Analysis lab, McConnell Brain Imaging Centre and Montreal Neurological Institute, McGill University, Montreal, Canada
4 Departments of Neurology, Neuroscience, and Neurosurgery, Yale University, New Haven, USA
5 Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil
6 Phramongkutklao hospital, Bangkok, Thailand
7 The Florey Institute of Neuroscience and Mental Health and The University of Melbourne, Australia
8 Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, USA
9 Department of Neurosurgery, University Hospital Erlangen, Germany
10 Neurology Unit, University of Modena and Reggio Emilia, Modena, Italy
11 Hotchkiss Brain Institute, University of Calgary, Canada
* Correspondence: Paolo Federico Room C1214a, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, Canada T2N 2T9

Magnetic resonance imaging (MRI) plays a central role in the management and evaluation of patients with epilepsy. It is important that structural MRI scans are optimally acquired and carefully reviewed by trained experts within the context of all available clinical data. The aim of this review is to discuss the essentials of MRI that will be useful to health care providers specialized in epilepsy, as outlined by the competencies and learning objectives of the recently developed ILAE curriculum. This review contains information on basic MRI principles, sequences, field strengths and safety, when to perform and repeat an MRI, epilepsy MRI protocol (HARNESS-MRI) and the basic reading guidelines, and common epileptic pathologies. More advanced topics such as MRI-negative epilepsy, functional MRI and diffusion-weighted imaging are also briefly discussed. Although the available resources can differ markedly across different centers, it is the hope that this review can provide general guidance in the everyday practice of using MRI for patients with epilepsy.

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