Magnetic source imaging in non-lesional neocortical epilepsy: additional value and comparison with ICEEG

Epilepsy Behav. 2012 Jun;24(2):234-40. doi: 10.1016/j.yebeh.2012.03.029. Epub 2012 Apr 28.

Abstract

Objective: To investigate the utility of magnetic source imaging (MSI) for localizing the epileptogenic zone (EZ) and predicting epilepsy surgery outcome in non-lesional neocortical focal epilepsy (NLNE) patients.

Methods: Data from 18 consecutive patients with NLNE who underwent presurgical evaluation including intracranial electroencephalography (ICEEG) and MSI were studied. Follow-up after epilepsy surgery was ≥24 months. Intracranial electroencephalography and MSI results were classified using a sublobar classification.

Results: Sublobar ICEEG focus was completely resected in 15 patients; seizure-free rate was 60%. Eight patients showed sublobar-concordant ICEEG/MSI results and complete resection of both regions; seizure-free rate was 87.5%. Seizure-free rate in cases not matching these criteria was only 30% (p=0.013).

Conclusions: Magnetoencephalography is a useful tool to localize the EZ and determine the site of surgical resection in NLNE patients. When sublobar concordance with ICEEG is observed, MSI increases the predictive value for a seizure-free epilepsy surgery outcome in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cohort Studies
  • Electroencephalography / methods*
  • Epilepsies, Partial / physiopathology*
  • Epilepsies, Partial / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Magnetoencephalography / methods*
  • Male
  • Middle Aged
  • Neocortex / physiopathology*
  • Neocortex / surgery
  • Neuroimaging / methods*
  • Neurosurgical Procedures
  • Predictive Value of Tests
  • Treatment Outcome
  • Young Adult