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

Authors :: Schneider F
Alexopoulos AV
Wang Z
Almubarak S
Kakisaka Y
Jin K
Nair D
Mosher JC
Najm IM
Burgess RC
Source :: Epilepsy & behavior : E&B [Epilepsy Behav] 2012 Jun; Vol. 24 (2), pp. 234-40. Date of Electronic Publication: 2012 Apr 28.
Publication Year :: 2012
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.<br />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.<br />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).<br />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.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)

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