Recent Developments of Simultaneous EEG/fMRI in Epilepsy – towards Clinical Application?*

Simultaneous EEG/fMRI recordings offer a unique approach of characterizing epileptic brain activity. The combination of high temporal resolution of EEG recordings and high spatial resolution of fMRI add to enhance the localization of rapidly fluctuating epileptic sources in the brain parenchyma. Scalp EEG/fMRI is a non-invasive, safe and reproducible brain imaging technique and is increasingly implemented in the clinical presurgical workup of epilepsy surgery. Formal validation of the clinical value of EEG/fMRI recordings is challenging but current state of research suggests that EEG/ fMRI analysis results in a comparable sensitivity compared to PET and SPECT imaging to identify the SOZ. In this review we discuss methodological considerations to identify and interpret epileptic activity in EEG/fMRI recordings, the proposed recent advances and ongoing challenges. Epileptologie 2012; 29: 90 – 98