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EEG source imaging in pediatric epilepsy surgery: a new perspective in presurgical workup.
Epilepsia 2006; 47(6):981-90E

Abstract

PURPOSE

Epilepsy is a relatively frequent disease in children, with considerable impact on cognitive and social life. Successful epilepsy surgery depends on unambiguous focus identification and requires a comprehensive presurgical workup, including several neuroimaging techniques [magnetic resonance imaging, positron emission tomography (PET), and single-photon emission computed tomography (SPECT)]. These may be difficult to apply in younger or developmentally delayed children or both, requiring sedation, and hence, a significant workforce. Modern electric source imaging (ESI) provides accurate epileptic source-localization information in most patients, with minimal patient discomfort or need for cooperation. The purpose of the present study was to determine the usefulness of ESI in pediatric EEG recordings performed with routine electrode arrays.

METHODS

Preoperative EEGs recorded from 19 to 29 scalp electrodes were reviewed, and interictal epileptiform activity was analyzed by using a linear source-imaging procedure (depth-weighted minimum norm) in combination with statistical parametric mapping.

RESULTS

In 27 (90%) of 30 patients, the ESI correctly localized the epileptogenic region. These numbers compare favorably with the results from other imaging techniques in the same patients (PET, 82%; ictal SPECT, 70%). In extratemporal epilepsy, ESI was correct in all cases, and in temporal lobe epilepsy, in 10 of 13 cases. In two temporal lobe patients showing less-accurate ESI results, 128-electrode data could be analyzed, and in both cases, the 128-electrode ESI was correct.

CONCLUSIONS

ESI with standard clinical EEG recordings provides excellent localizing information in pediatric patients, in particular in extratemporal lobe epilepsy. The lower yield in temporal lobe epilepsy seems to be due to undersampling of basal temporal areas with routine scalp recordings.

Authors+Show Affiliations

University of Rome Tor Vergata, Rome, Italy, and Functional Brain Mapping Laboratory, Neurology Clinic, University Hospital, Geneva, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16822244

Citation

Sperli, Francesca, et al. "EEG Source Imaging in Pediatric Epilepsy Surgery: a New Perspective in Presurgical Workup." Epilepsia, vol. 47, no. 6, 2006, pp. 981-90.
Sperli F, Spinelli L, Seeck M, et al. EEG source imaging in pediatric epilepsy surgery: a new perspective in presurgical workup. Epilepsia. 2006;47(6):981-90.
Sperli, F., Spinelli, L., Seeck, M., Kurian, M., Michel, C. M., & Lantz, G. (2006). EEG source imaging in pediatric epilepsy surgery: a new perspective in presurgical workup. Epilepsia, 47(6), pp. 981-90.
Sperli F, et al. EEG Source Imaging in Pediatric Epilepsy Surgery: a New Perspective in Presurgical Workup. Epilepsia. 2006;47(6):981-90. PubMed PMID: 16822244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EEG source imaging in pediatric epilepsy surgery: a new perspective in presurgical workup. AU - Sperli,Francesca, AU - Spinelli,Laurent, AU - Seeck,Margitta, AU - Kurian,Mary, AU - Michel,Christoph M, AU - Lantz,Göran, PY - 2006/7/11/pubmed PY - 2006/7/29/medline PY - 2006/7/11/entrez SP - 981 EP - 90 JF - Epilepsia JO - Epilepsia VL - 47 IS - 6 N2 - PURPOSE: Epilepsy is a relatively frequent disease in children, with considerable impact on cognitive and social life. Successful epilepsy surgery depends on unambiguous focus identification and requires a comprehensive presurgical workup, including several neuroimaging techniques [magnetic resonance imaging, positron emission tomography (PET), and single-photon emission computed tomography (SPECT)]. These may be difficult to apply in younger or developmentally delayed children or both, requiring sedation, and hence, a significant workforce. Modern electric source imaging (ESI) provides accurate epileptic source-localization information in most patients, with minimal patient discomfort or need for cooperation. The purpose of the present study was to determine the usefulness of ESI in pediatric EEG recordings performed with routine electrode arrays. METHODS: Preoperative EEGs recorded from 19 to 29 scalp electrodes were reviewed, and interictal epileptiform activity was analyzed by using a linear source-imaging procedure (depth-weighted minimum norm) in combination with statistical parametric mapping. RESULTS: In 27 (90%) of 30 patients, the ESI correctly localized the epileptogenic region. These numbers compare favorably with the results from other imaging techniques in the same patients (PET, 82%; ictal SPECT, 70%). In extratemporal epilepsy, ESI was correct in all cases, and in temporal lobe epilepsy, in 10 of 13 cases. In two temporal lobe patients showing less-accurate ESI results, 128-electrode data could be analyzed, and in both cases, the 128-electrode ESI was correct. CONCLUSIONS: ESI with standard clinical EEG recordings provides excellent localizing information in pediatric patients, in particular in extratemporal lobe epilepsy. The lower yield in temporal lobe epilepsy seems to be due to undersampling of basal temporal areas with routine scalp recordings. SN - 0013-9580 UR - https://www.unboundmedicine.com/medline/citation/16822244/EEG_source_imaging_in_pediatric_epilepsy_surgery:_a_new_perspective_in_presurgical_workup_ L2 - https://doi.org/10.1111/j.1528-1167.2006.00550.x DB - PRIME DP - Unbound Medicine ER -