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Characterizing magnetic spike sources by using magnetoencephalography-guided neuronavigation in epilepsy surgery in pediatric patients.
J Neurosurg. 2005 Mar; 102(2 Suppl):187-96.JN

Abstract

OBJECT

The authors sought to validate magnetoencephalography spike sources (MEGSSs) in neuronavigation during epilepsy surgery in pediatric patients.

METHODS

The distributions of MEGSSs in 16 children were defined and classified as clusters (Class I), greater than or equal to 20 MEGSSs with 1 cm or less between MEGSSs; small clusters (Class II), 6 to 19 with 1 cm or less between; and scatters (Class III), less than 6 or greater than 1 cm between spike sources. Using neuronavigation, the MEGSSs were correlated to epileptic zones from intra- and extraoperative electrocorticography (ECoG), surgical procedures, disease entities, and seizure outcomes. Thirteen patients underwent MEGSSs: nine had clusters; two had small clusters, one with and one without clusters; and three had scatters alone. All 13 had scatters. Clusters localized within and extended from areas of cortical dysplasia and at margins of tumors or cystic lesions. All clusters were colocalized to ECoG-defined epileptic zones. Four of 10 patients with clusters and/or small clusters underwent complete excisions, and six underwent partial excision with or without multiple subpial transections. In the three patients with scatters alone, ECoG revealed epileptic zones buried within MEGSS areas; these regions of scatters were completely excised and treated with multiple subpial transections. Coexisting scatters were left untreated in nine of 10 patients. Postoperatively, nine of 13 patients were seizure free; the four patients with residual seizures had clusters in unresected eloquent cortex. Three patients in whom no MEGSSs were demonstrated underwent lesionectomies and were seizure free.

CONCLUSIONS

Magnetoencephalography spike source clusters indicate an epileptic zone requiring complete excision. Coexisting scatters remote from clusters are nonepileptogenic and do not require excision. Scatters alone, however, should be examined by ECoG; an epileptic zone may exist within these distributions.

Authors+Show Affiliations

Division of Neurology, The Hospital for Sick Children and University of Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16156229

Citation

Iida, Koji, et al. "Characterizing Magnetic Spike Sources By Using Magnetoencephalography-guided Neuronavigation in Epilepsy Surgery in Pediatric Patients." Journal of Neurosurgery, vol. 102, no. 2 Suppl, 2005, pp. 187-96.
Iida K, Otsubo H, Matsumoto Y, et al. Characterizing magnetic spike sources by using magnetoencephalography-guided neuronavigation in epilepsy surgery in pediatric patients. J Neurosurg. 2005;102(2 Suppl):187-96.
Iida, K., Otsubo, H., Matsumoto, Y., Ochi, A., Oishi, M., Holowka, S., Pang, E., Elliott, I., Weiss, S. K., Chuang, S. H., Snead, O. C., & Rutka, J. T. (2005). Characterizing magnetic spike sources by using magnetoencephalography-guided neuronavigation in epilepsy surgery in pediatric patients. Journal of Neurosurgery, 102(2 Suppl), 187-96.
Iida K, et al. Characterizing Magnetic Spike Sources By Using Magnetoencephalography-guided Neuronavigation in Epilepsy Surgery in Pediatric Patients. J Neurosurg. 2005;102(2 Suppl):187-96. PubMed PMID: 16156229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterizing magnetic spike sources by using magnetoencephalography-guided neuronavigation in epilepsy surgery in pediatric patients. AU - Iida,Koji, AU - Otsubo,Hiroshi, AU - Matsumoto,Yuuri, AU - Ochi,Ayako, AU - Oishi,Makoto, AU - Holowka,Stephanie, AU - Pang,Elizabeth, AU - Elliott,Irene, AU - Weiss,Shelly K, AU - Chuang,Sylvester H, AU - Snead,O Carter,3rd AU - Rutka,James T, PY - 2005/9/15/pubmed PY - 2005/10/12/medline PY - 2005/9/15/entrez SP - 187 EP - 96 JF - Journal of neurosurgery JO - J Neurosurg VL - 102 IS - 2 Suppl N2 - OBJECT: The authors sought to validate magnetoencephalography spike sources (MEGSSs) in neuronavigation during epilepsy surgery in pediatric patients. METHODS: The distributions of MEGSSs in 16 children were defined and classified as clusters (Class I), greater than or equal to 20 MEGSSs with 1 cm or less between MEGSSs; small clusters (Class II), 6 to 19 with 1 cm or less between; and scatters (Class III), less than 6 or greater than 1 cm between spike sources. Using neuronavigation, the MEGSSs were correlated to epileptic zones from intra- and extraoperative electrocorticography (ECoG), surgical procedures, disease entities, and seizure outcomes. Thirteen patients underwent MEGSSs: nine had clusters; two had small clusters, one with and one without clusters; and three had scatters alone. All 13 had scatters. Clusters localized within and extended from areas of cortical dysplasia and at margins of tumors or cystic lesions. All clusters were colocalized to ECoG-defined epileptic zones. Four of 10 patients with clusters and/or small clusters underwent complete excisions, and six underwent partial excision with or without multiple subpial transections. In the three patients with scatters alone, ECoG revealed epileptic zones buried within MEGSS areas; these regions of scatters were completely excised and treated with multiple subpial transections. Coexisting scatters were left untreated in nine of 10 patients. Postoperatively, nine of 13 patients were seizure free; the four patients with residual seizures had clusters in unresected eloquent cortex. Three patients in whom no MEGSSs were demonstrated underwent lesionectomies and were seizure free. CONCLUSIONS: Magnetoencephalography spike source clusters indicate an epileptic zone requiring complete excision. Coexisting scatters remote from clusters are nonepileptogenic and do not require excision. Scatters alone, however, should be examined by ECoG; an epileptic zone may exist within these distributions. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/16156229/Characterizing_magnetic_spike_sources_by_using_magnetoencephalography_guided_neuronavigation_in_epilepsy_surgery_in_pediatric_patients_ L2 - https://thejns.org/doi/10.3171/jns.2005.102.2.0187 DB - PRIME DP - Unbound Medicine ER -