Magnetoencephalography-identified preictal spiking correlates to preictal spiking on stereotactic EEG

Andrew Zillgitt; Mohamad Ayman Haykal; Konstantin Elisevich; Sanjay Patra; Frederick Sherburn; Susan M Bowyer; David E Burdette

doi:10.1016/j.ebr.2022.100538

Magnetoencephalography-identified preictal spiking correlates to preictal spiking on stereotactic EEG

Epilepsy Behav Rep. 2022 Mar 24:19:100538. doi: 10.1016/j.ebr.2022.100538. eCollection 2022.

Authors

Andrew Zillgitt¹, Mohamad Ayman Haykal², Konstantin Elisevich³, Sanjay Patra³, Frederick Sherburn⁴, Susan M Bowyer⁴, David E Burdette²

Affiliations

¹ Department of Neurology, Beaumont Health, Royal Oak, MI, United States.
² Department of Neurology, Spectrum Health, Grand Rapids, MI, United States.
³ Department of Neurosurgery, Spectrum Health, Grand Rapids, MI, United States.
⁴ Department of Neurology, Henry Ford Health System, Detroit, MI, United States.

Abstract

Magnetoencephalography (MEG) is a noninvasive diagnostic modality that directly measures neuronal signaling by recording the magnetic field created from dendritic, intracellular, electrical currents of the neuron at the surface of the head. In clinical practice, MEG is used in the epilepsy presurgical evaluation and most commonly is an "interictal" study that can provide source localization of spike-wave discharges. However, seizures may be recorded during MEG ("ictal MEG") and mapping of these discharges may provide more accurate localization of the seizure onset zone. In addition, spike-negative EEG with unique MEG spike-waves may be present in up to 1/3 of MEG studies and unique MEG seizures (EEG-negative seizures) have been reported. This case report describes a patient with unique MEG seizures that exhibited MEG pre-ictal spiking in a tight cluster consistent with the independent interictal epileptiform activity. Stereotactic EEG demonstrated pre-ictal spiking concordant with the MEG pre-ictal spiking.

Keywords: Drug-resistant epilepsy; Epilepsy surgery; Magnetoencephalography; Responsive neural stimulation; Stereo-EEG.

Publication types

Case Reports