Fig. 2.

Multimodal neuroimaging (MRI, DTI, MEG, etc.) in source localization.

A. Presurgical ¹H MR spectroscopy and MRI of a patient with TLE, who has hippocampal sclerosis in the left hippocampus (with decreased NAA in ¹H MRS) and the seizure focus is in the left anterior temporal region.

B. FDG-PET scan of a patient with bilateral TLE. Hypometabolism is seen in the temporal lobes of both hemispheres with lower hypometabolism in the right temporal region. Other neuroimaging tests are needed to further localize the dominant seizure focus.

C. (De Tiègea et al., 2008; courtesy of Dr Xavier De Tiège; reprinted with permission from De Tiègea et al., 2008) Right posterior temporal sources detected by MEG found in a patient shown on the co-registered 3D-T1 MRI.

D. Fiber tracking from DTI scan: Corticospinal tract (CST) tracking to assess diffusion abnormalities in a patient before functional hemispherectomy.

E. Presurgical EEG–fMRI of a patient with bilateral TLE and ETLE, and EEG–fMRI identified seizure foci in both hemispheres with major right frontal and temporal sources.