Epilepsy is a clinical syndrome characterized by recurrent epileptic seizures caused by various etiologies. Etiological diagnosis and localization of the epileptogenic focus are of great importance in the treatment of epilepsy. Positron emission tomography-computed tomography (PET-CT) technology plays a significant role in the etiological diagnosis and localization of the epileptogenic focus in epilepsy. It also guides the treatment of epilepsy, predicts the prognosis, and helps physicians intervene earlier and improve the quality of life of patients. With the continuous development of PET-CT technology, more hope and better treatment options will be provided for epilepsy patients. This article will review the guiding role of PET-CT technology in the diagnosis and treatment of epilepsy, providing insights into its application in etiological diagnosis, preoperative assessment of the condition, selection of treatment plans, and prognosis of epilepsy.
Epilepsy is a common chronic neurological disorder. Drug-resistant epilepsy (DRE) is defined as failure to achieve sustained seizure freedom after adequate trials of two appropriately chosen and tolerated anti-seizure medications (ASMs) regimens (as monotherapies or in combination). In this population, surgical resection and neuromodulation can effectively reduce seizure burden; however, their effectiveness is limited by uncertainty in epileptogenic zone localization, interindividual variability in stimulation targets and parameters, and procedure-related risks. As an emerging technology, brain–computer interface (BCI) offer a closed-loop framework of real-time monitoring, state decoding, decision-making, and intervention delivery, shifting therapy from fixed-parameter open-loop approaches to biomarker-driven, dynamically personalized modulation and providing new avenues for precision, individualized treatment of DRE. This review summarizes signal acquisition and decoding strategies for epilepsy BCI, closed-loop intervention paradigms, and key challenges in clinical translation.
Approximately 70 million people worldwide suffer from epilepsy, with about 9 million in China. About one-third of patients demonstrating resistance to traditional antiseizure medications (ASMs), Focal Cortical Stimulation (FCS) emerges as a novel neuromodulation therapy based on neural stimulation, showing potential in treating drug-resistant focal epilepsy. FCS reduces seizure frequency by diminishing abnormal excitability in cortical areas. Compared to traditional surgery, it carries lower risks and is particularly suited for patients whose epileptogenic foci are difficult to surgically localize. Its adjustability provides physicians with treatment flexibility, allowing them to tailor therapy based on patient conditions. Recent studies highlight the practical clinical application of FCS, underscoring its advantages in reducing the frequency of drug-resistant epilepsy seizures. The article concludes by exploring the future prospects of FCS, emphasizing the need for research in long-term efficacy assessment and patient adaptability, thus demonstrating its significant potential and direction for development in the field of epilepsy treatment.
