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Magnetoencephalographic localization in pediatric epilepsy surgery: Comparison with invasive intracranial electroencephalography
Author(s) -
Minassian Berge A.,
Otsubo Hiroshi,
Weiss Shelly,
Elliott Irene,
Rutka James T.,
Snead O. Carter
Publication year - 1999
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(199910)46:4<627::aid-ana11>3.0.co;2-c
Subject(s) - ictal , epilepsy surgery , magnetoencephalography , epilepsy , ictal interictal spect analysis by spm , electroencephalography , electrocorticography , medicine , somatosensory system , cortex (anatomy) , anesthesia , psychology , neuroscience
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.