Candidates for epilepsy surgery must undergo presurgical evaluation to establish whether and how surgical treatment can stop seizures without causing neurological deficits. Various techniques, including MRI, PET, single-photon emission CT, video-EEG, magnetoencephalography and invasive EEG, aim to identify the diseased brain tissue and the involved network. Recent technical and methodological developments, encompassing both advances in existing techniques and new combinations of technologies, are enhancing the ability to define the optimal resection strategy. Multimodal interpretation and predictive computer models are expected to aid surgical planning and patient counselling, and multimodal intraoperative guidance is likely to increase surgical precision. In this Review, we discuss how the knowledge derived from these new approaches is challenging our way of thinking about surgery to stop focal seizures. In particular, we highlight the importance of looking beyond the EEG seizure onset zone and considering focal epilepsy as a brain network disease in which long-range connections need to be taken into account. We also explore how new diagnostic techniques are revealing essential information in the brain that was previously hidden from view.

中文翻译：

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癫痫手术的术前评估中观念的改变。

癫痫手术的候选人必须接受术前评估，以确定手术治疗是否以及如何能够在不引起神经功能缺损的情况下停止癫痫发作。各种技术（包括MRI，PET，单光子发射CT，视频脑电图，脑磁图和侵入性脑电图）旨在识别患病的脑组织和受累的网络。最近的技术和方法学发展，既包括现有技术的进步，又包括技术的新组合，正在增强定义最佳切除策略的能力。预计多模式解释和预测性计算机模型将有助于手术计划和患者咨询，多模式术中指导可能会提高手术精度。在这篇评论中，我们将讨论从这些新方法中获得的知识如何挑战我们有关停止局灶性癫痫发作的外科手术思维方式。特别是，我们强调了超越EEG癫痫发作区并考虑将局灶性癫痫视为需要考虑远距离连接的脑网络疾病的重要性。我们还探索了新的诊断技术如何揭示大脑中以前看不见的基本信息。