There is no single test in the world that can locate the epileptogenic focus with 100% accuracy and reliability. The main methods to locate the epileptogenic focus include: manifestation of the patient’s seizure process; examination of anatomical structures (such as CT, MRI, etc.); electrophysiological examination (various types of EEG and magnetoencephalography); nuclear medicine examination (SPET, PET-CT); neuropsychological examination, etc. Doctors should choose various examination means reasonably according to the type of occurrence of patients and their financial affordability. Generally, the results are more reliable if multiple examination means suggest the same localization information, among which electrophysiological examination results are dominant, and currently the main ones are long-range video EEG, intracranial implanted electrode EEG, electrical stimulation to localize the epileptogenic focus, and high frequency EEG to localize the epileptogenic focus. Epilepsy is a symptomatic diagnosis, and lesions in almost any part of the brain can cause seizures. Epilepsy therefore has many types, and each type of epilepsy has a different treatment and prognosis. Especially in patients with intractable epilepsy requiring surgery, the location of the epileptic focus and functional areas of the cerebral cortex also need to be determined. Due to the complexity of epilepsy, there is no method that can accurately and unambiguously suggest the location of the epileptic focus. In most cases, MRI and CT can show structural changes in the brain, and PET can indicate the metabolism of brain tissue. Functional MRI can indicate the location of functional areas of the cerebral cortex. Intracranial buried electrode EEG helps to determine the location of the epileptic focus more precisely. Therefore, the combination of multiple tests is essential in the preoperative evaluation of epilepsy.
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