1. Ictal and interictal MEG in pediatric patients with tuberous sclerosis and drug resistant epilepsy
- Author
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Ritva Paetau, A M Koptelova, R. Bikmullina, M. Korsakova, A G Melikyan, Novikova Si, Golovteev Al, Mordekhay Medvedovsky, Olesya Grinenko, Liisa Metsähonkala, A. Vorobyev, A B Kozlova, Stroganova Ta, Arkhipova Na, HUS Medical Imaging Center, BioMag Laboratory, University of Helsinki, Clinicum, Kliinisen neurofysiologian yksikkö, Department of Neurosciences, Lastenneurologian yksikkö, Children's Hospital, and HUS Children and Adolescents
- Subjects
Male ,medicine.medical_specialty ,Drug Resistant Epilepsy ,Adolescent ,Electroencephalography ,behavioral disciplines and activities ,3124 Neurology and psychiatry ,030218 nuclear medicine & medical imaging ,Resection ,03 medical and health sciences ,Tuberous sclerosis ,Epilepsy ,0302 clinical medicine ,Epilepsy surgery ,3123 Gynaecology and paediatrics ,Seizures ,Tuberous Sclerosis ,medicine ,Humans ,Ictal ,EEG ,Child ,Brain Mapping ,Intraoperative Care ,medicine.diagnostic_test ,business.industry ,musculoskeletal, neural, and ocular physiology ,Ictal and interictal MEG ,3112 Neurosciences ,Brain ,Magnetoencephalography ,medicine.disease ,Epileptogenic zone ,3. Good health ,nervous system diseases ,Treatment Outcome ,Neurology ,nervous system ,Child, Preschool ,Female ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,psychological phenomena and processes - Abstract
Purpose Drug resistant epilepsy (DRE) is common in patients with tuberous sclerosis (TS). Interictal MEG has been shown as a valuable instrument in the presurgical workup. The goal of our study was to evaluate the role of ictal MEG in epileptogenic tuber selection, especially in patients with multiple irritative zones. Methods The clinical and MEG data of 23 patients with TS and DRE from two medical/research centers were reviewed. Seven pediatric patients, who had seizures during MEG recording and underwent resection or disconnection surgery, were included into the study. Cortical sources of ictal and interictal epileptiform MEG discharges were compared with epileptogenic zone location in six patients with favorable surgery outcome. Results In patients who improved substantially after surgery all resected and several other tubers demonstrated epileptiform activity on interictal MEG. Ictal MEG provided crucial information about lobar location of the seizure onset zone (SOZ) in two cases, and in the other four it confirmed the SOZ location derived from the interictal data. In one case, ictal MEG findings were unreliable. In one patient, who did not benefit from surgical treatment, the resected tubers did not overlap with interictal and ictal MEG sources. Conclusion The combination of interictal and ictal MEG is a valuable tool for identification of the epileptogenic tuber/tubers in presurgical work-up in patients with TS.
- Published
- 2017