Magnetoencephalographic localization in pediatric epilepsy surgery: Comparison with invasive intracranial electroencephalography

The object of this study was to determine the concordance of the anatomical location of interictal magnetoencephalographic (MEG) spike foci with the location of ictal onset zones identified by invasive ictal intracranial electroencephalographic recordings in children undergoing evaluation for epilep...

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Bibliographic Details
Published in:Annals of neurology 1999-10, Vol.46 (4), p.627-633
Main Authors: Minassian, Berge A., Otsubo, Hiroshi, Weiss, Shelly, Elliott, Irene, Rutka, James T., Snead III, O. Carter
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Brain - physiopathology
Brain - surgery
Brain Mapping
Child
Child, Preschool
Electroencephalography - methods
Epilepsy - physiopathology
Epilepsy - surgery
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Magnetoencephalography
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Prognosis
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Summary:The object of this study was to determine the concordance of the anatomical location of interictal magnetoencephalographic (MEG) spike foci with the location of ictal onset zones identified by invasive ictal intracranial electroencephalographic recordings in children undergoing evaluation for epilepsy surgery. MEG was performed in 11 children with intractable, nonlesional, extratemporal, localization‐related epilepsy. Subsequently, chronic invasive intracranial electroencephalographic monitoring was performed by using subdural electrodes to localize the ictal onset zone and eloquent cortex. Based on the invasive monitoring data, all children had excision of, or multiple subpial transections through, ictal onset cortex and surrounding irritative zones. In 10 of 11 patients, the anatomical location of the epileptiform discharges as determined by MEG corresponded to the ictal onset zone established by ictal intracranial recordings. In all children, the anatomical location of the somatosensory hand area, determined by functional mapping through the subdural electrode array, was the same as that delineated by MEG. Nine of 11 patients became either seizure‐free or had a greater than 90% reduction in seizures after surgery, with a mean follow‐up of 24 months. MEG is a powerful and accurate tool in the presurgical evaluation of children with refractory nonlesional extratemporal epilepsy.
ISSN:0364-5134
1531-8249
DOI:10.1002/1531-8249(199910)46:4<627::AID-ANA11>3.0.CO;2-C