An analysis of 27 studies involving over 3000 patients with drug resistant temporal lobe epilepsy has shed light on the value of various type of neuroimaging. Seven studies suggest that clinical outcomes are more favorable when patients have MRI-identified hippocampal atrophy and mesial temporal sclerosis. On the other hand, 5 studies concluded that outcomes were less favorable when patients had unremarkable MIR findings. The value of PET imaging seems less clear. Study findings were inconsistent on the prognostic value of PET-identified focal hypometabolism, for instance.
Jones AL, Cascino GD. Evidence on Use of Neuroimaging for Surgical Treatment of Temporal Lobe Epilepsy: A Systematic Review. JAMA Neurol. 2016;73(4):464-470.