Lesion network mapping in pediatric epilepsy.

OBJECTIVE: To describe the current use, limitations, and future directions of lesion network mapping in pediatric epilepsy. METHODS: Narrative review of lesion network mapping with a comprehensive review of the lesion network mapping pediatric epilepsy literature available in PubMed. RESULTS: Our search yielded ten studies using lesion network mapping in pediatric epilepsy. Lesion network mapping combines widely accessible conventional brain magnetic resonance imaging (MRI) with publicly available normative human connectome data to reveal the pathological neural networks that cause several neuropsychiatric symptoms. Currently, there are few studies using lesion network mapping in pediatric epilepsy and they are limited because of heterogeneous methodologies, small sample sizes, non-age-matched connectome data, and lack of replication cohorts. Aggregate results are heterogeneous. Future lesion network mapping studies with larger sample sizes and a standard agreed-upon methodology may elucidate the neural networks causing developmental and epileptic encephalopathies, epileptogenesis after early developmental lesions, and may open the door to targeted treatment approaches in pediatric epilepsy. CONCLUSION: Lesion network mapping for pediatric epilepsy is in its infancy and results are heterogeneous.