Background: Real-time, direct assessment of brain electrophysiology is critical for noninvasive functional mapping and for the identification of paroxysmal epileptiform abnormalities in the evaluation of patients for epilepsy surgery. Historically, electroencephalography (EEG) and evoked potentials (EPs) have performed these functions. However, both often required direct intracranial recording for precise localization. Magnetoencephalography (MEG) takes advantage of the fact that neuromagnetic signals penetrate the skull and scalp without distortion. The magnetic source image (MSI) is created when the MEG data is superimposed on a magnetic resonance image (MRI).
Review summary: MEG performs noninvasive functional imaging by recording the magnetic flux on the head surface associated with electrical currents in activated sets of neurons. MEG has rapidly evolved in the last 2 decades because of the introduction of whole head systems and advances in computer technology. MEG is now the imaging modality of choice where a precise and high degree of localization is required. MEG can be used to localize the primary sensory cortices (visual, auditory, or somatosensory), areas involved with receptive language function, the irritative zone in epilepsy patients, and identify children with anomalous language development. This article reviews the basis of MEG, the instrumentation used, the clinical applications and current limits of the technology.
Conclusion: MEG studies can now be performed on a routine basis as a clinical tool. MEG is now indicated for: 1) localization of the irritative zone in lesional and nonlesional epilepsy surgery patients, 2) functional mapping of eloquent cortex, and 3) assessment of normal and abnormal language development. In the future MEG may help the understanding of normal development and reorganization after brain injury. The neurologist can use MEG data to complement structural and metabolic imaging techniques.