Imaging in Epilepsy: Current Clinical Practice and Future Directions

Neuroimaging is an essential part of epilepsy diagnosis and management. In this review, we examine the shift in our understanding of epilepsy from a focal, lesional-centric process to a broader, network-based disorder and how it has affected the acquisition and interpretation of neuroimaging for epilepsy diagnosis and management. We discuss the current clinical practice of neuroimaging in epilepsy, both in terms of acquisitions and interpretation, through computed tomography, magnetic resonance imaging (including structural, diffusion, functional, and high-field), magnetoencephalography, and nuclear and metabolic imaging. Additionally, we look ahead to some of the latest research advances in both the acquisition and analysis of these different neuroimaging modalities to help promote the eventual goal of a consolidated, multi-modality imaging approach to understanding, diagnosing, and treating epilepsy.