Electric source imaging for presurgical epilepsy evaluation: current status and future prospects

Introduction: Electric source imaging (ESI) refers to the estimation of the cerebral sources of electric signals recorded at the head surface using electroencephalography (EEG). Thanks to the availability of EEG systems with high numbers of electrodes and to progress in software to analyze the signals they collect, ESI can be applied to epilepsy-related pathological EEG signals like interictal spikes and seizures.Areas covered: In this narrative review, we discuss selected original research articles on the use of ESI in epilepsy patients considered for surgery. Epilepsy-related activity can be localized accurately using ESI, as established by comparison to the gold standards of intracranial EEG and seizure control following epilepsy surgery. The information brought by ESI complements successfully that of other techniques like magnetic resonance imaging and positron-emission tomography, and is clinically relevant to patient management.Expert opinion: EEG is a readily available technique to measure brain activity in real time. Given its accuracy and usefulness, ESI should become part of the routine practice of clinical neurophysiology laboratories and epilepsy centers in the presurgical management of epilepsy patients