Magnetoencephalography for Evaluation of Pediatric Intractable Epilepsy
Abstract number :
2.200
Submission category :
Year :
2001
Submission ID :
3056
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
S.H. Chuang, MD, Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada; H. Otsubo, MD, Clinical Neurophysiology, The Hospital for Sick Children, Toronto, ON, Canada; J. Xiang, MD, Diagnostic Imaging, The Hospital for Sick Children, Toron
RATIONALE: Magnetoencephalography (MEG) has been reported to demonstrate interictal spike sources for children with epilepsy. We analyze how sensitive and specific is this non-invasive advanced neurophysiological modality using whole head MEG for evaluation in intractable seizure disorders.
METHODS: Thirty-four patients, age ranging between 6 and 16 years (mean, 12 years), were studied with 151 channel MEG for localizing epileptic spikes and somatosensory evoked fields since September 2000. The patients were deprived sleep night before and lying position during the MEG study. Fifteen to 20 sets of 2 minute spontaneous MEG and EEG recording were corrected and analyzed. The MEG spike sources were overlaid on patient[ssquote]s MRI to demonstrate magnetic source imaging (MSI).
RESULTS: Twenty-eight patients who had appropriate MEG spikes were analyzed for localization of epileptic spike sources (sensitivity 82%). In 22 (specificity 64%) patients, MEG spike sources provided advanced information, consisting of decision of epilepsy surgery (14 patients), confirmation of epilepsy type (5), and reconsideration of medical management (3). Twelve patients (36%) did not receive any further information from MEG study because of discordant results to the other neuroimaging studies in 6 patients, inconclusive MEG data due to very few and inconsistent spikes in 3, and no MEG and EEG spike in 3.
CONCLUSIONS: In children with intractable localization-related epilepsy, MSI localizes the zone of epileptogenesis adjacent to the lesion or to the ictal EEG region, to decide surgical intervention. Information from simultaneous MEG and EEG study provides further seizure managements for pediatric refractory epilepsy.