Authors' objectives: To assess the role of high cost functional diagnostic imaging in routine management of refractory epilepsy. The technologies considered were positron emission tomography (PET), magnetic resonance spectroscopy (MRS), functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) when used with MRI as magnetic source imaging (MSI).

Authors' results and conclusions: The potential role of all of these techniques in epilepsy would be in diagnosis and work-up of patients with medically refractory epilepsy (MRE), who have no evidence of lesions on MRI or other anatomical imaging methods. In the clinical situation, all would be used as complementary techniques to anatomical imaging methods such as MRI, and would increase costs of management. Possibly 50 to 100 such patients per year in Alberta might benefit from use of these function diagnostic imaging methods. MEG has been studied for many years as a method for use in epilepsy, but remains in the developmental stage with its clinical role yet to be defined. MRS provides unique information on cerebral metabolism but it is not established as a method in management of epilepsy. fMRI is a promising technology for application to epilepsy, but at this stage remains a research tool. PET has advantages over existing functional imaging methods in terms of accuracy of localization of lesions in patients with MRE. However, it has not yet been able to replace other technologies, and is not helpful for many patients with non-temporal lobe epilepsy.

Authors' recommendations: Of the functional diagnostic imaging methods considered, only PET has a potential place in routine management of some epilepsy patients. Further work would be needed to define its role and economic costs and benefits.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 1998

URL for published report: http://www.ihe.ca/advanced-search/functional-diagnostic-imaging-in-epilepsy

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research</p>