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EEG‐Triggered Functional MRI in Patients With Pharmacoresistant Epilepsy
Author(s) -
Lazeyras François,
Blanke Olaf,
Perrig Steven,
Zimine Ivan,
Golay Xavier,
Delavelle Jacqueline,
Michel Christoph M.,
de Tribolet Nicolas,
Villemure JeanGuy,
Seeck Margitta
Publication year - 2000
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/1522-2586(200007)12:1<177::aid-jmri20>3.0.co;2-3
Subject(s) - ictal , electroencephalography , eeg fmri , epilepsy , magnetic resonance imaging , medicine , epilepsy surgery , focus (optics) , functional magnetic resonance imaging , radiology , neuroscience , psychology , physics , optics
Functional magnetic resonance imaging (fMRI) triggered by scalp electroencephalography (EEG) recordings has become a promising new tool for noninvasive epileptic focus localization. Studies to date have shown that it can be used safely and that highly localized information can be obtained. So far, no reports using comprehensive clinical information and/or long‐term follow‐up after epilepsy surgery in a larger patient group have been given that would allow a valuable judgment of the utility of this technique. Here, the results of 11 patients with EEG‐triggered fMRI exams who also underwent presurgical evaluation of their epilepsy are given. In most patients we were able to record good quality EEG inside the magnet, allowing us to trigger fMRI acquisition by interictal discharges. The fMRI consisted of echoplanar multislice acquisition permitting a large anatomical coverage of the patient's brain. In 8 of the 11 patients the exam confirmed clinical diagnosis, either by the presence ( n = 7) or absence ( n = 1) of focal signal enhancement. In six patients, intracranial recordings were carried out, and in five of them, the epileptogenic zone as determined by fMRI was confirmed. Limitations were encountered a) when the focus was too close to air cavities; b) if an active epileptogenic focus was absent; and c) if only reduced cooperation with respect to body movements was provided by the patient. We conclude that EEG‐triggered fMRI is a safe and powerful noninvasive tool that improves the diagnostic value of MRI by localizing the epileptic focus precisely. J. Magn. Reson. Imaging 2000;12:177–185. © 2000 Wiley‐Liss, Inc.