The use of functional MRI (fMRI) may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE), temporal epilepsy in general, or extratemporal epilepsy. In a recent study, an 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process, in order to assess the diagnostic accuracy and prognostic value of functional fMRI in determining lateralization and predicting postsurgical language and memory outcomes. Researchers found:

• For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient.
• fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection.
• The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE but is of unclear utility in other epilepsy types.