Pre-surgical Evaluation

Main concept: two things should be true if we are going to consider this option:

• All the seizures should arise from the same part of the brain.
• There should be no important function in the part of the brain that will be removed.

How do we prove this? In order prove that this is true, we have to do some testing:

Tests to prove that all seizures arise from the same part of the brain include:
• Video-EEG monitoring
• MEG (magnetoencephalogram)
• Imaging studies:
  - High resolution MRI
  - PET scan (positron emission tomography)
  - SPECT (single photon emission computed tomography)
  - MRS (MR spectroscopy)

Tests to prove that it is safe to perform surgery include:
• Neuropsychological testing
• fMRI (functional MRI)
• Wada test Wada test (amytal test)