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Utility of magnetoencephalography in the evaluation of recurrent seizures after epilepsy surgery.
Epilepsia. 2007 Nov; 48(11):2150-9.E

Abstract

PURPOSE

To study the role of magnetoencephalography (MEG) in the surgical evaluation of children with recurrent seizures after epilepsy surgery.

METHODS

We studied 17 children with recurrent seizures after epilepsy surgery using interictal and ictal scalp EEG, intracranial video EEG (IVEEG), MRI, and MEG. We analyzed the location and distribution of MEG spike sources (MEGSSs) and the relationship of MEGSSs to the margins of previous resections and surgical outcome.

RESULTS

Clustered MEGSSs occurred at the margins of previous resections within two contiguous gyri in 10 patients (group A), extended spatially from a margin by < or =3 cm in three patients (group B), and were remote from a resection margin by >3 cm in six patients (group C). Two patients had concomitant group A and C clusters. Thirteen patients underwent second surgeries. IVEEG was used in four patients. Six of seven patients with group A MEGSS clusters did not require IVEEG for second surgeries. Follow-up periods ranged from 0.6 to 4.3 years (mean: 2.6 years). Eleven children, including eight who became seizure-free, achieved Engel class I or II.

CONCLUSION

Our data demonstrate the utility of MEG for evaluating patients with recurrent seizures after epilepsy surgery. Specific MEGSS cluster patterns delineate epileptogenic zones. Removing cluster regions adjacent to the margins of previous resections, in addition to removing recurrent lesions, achieves favorable surgical outcome. Cluster location and extent identify which patients require IVEEG, potentially eliminating IVEEG for some. Patients with remotely located clusters require IVEEG for accurate assessment and localization of the entire epileptogenic zone.

Authors+Show Affiliations

Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Unviersity of Toronto, 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 available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

17727666

Citation

Mohamed, Ismail S., et al. "Utility of Magnetoencephalography in the Evaluation of Recurrent Seizures After Epilepsy Surgery." Epilepsia, vol. 48, no. 11, 2007, pp. 2150-9.
Mohamed IS, Otsubo H, Ochi A, et al. Utility of magnetoencephalography in the evaluation of recurrent seizures after epilepsy surgery. Epilepsia. 2007;48(11):2150-9.
Mohamed, I. S., Otsubo, H., Ochi, A., Elliott, I., Donner, E., Chuang, S., Sharma, R., Holowka, S., Rutka, J., & Snead, O. C. (2007). Utility of magnetoencephalography in the evaluation of recurrent seizures after epilepsy surgery. Epilepsia, 48(11), 2150-9.
Mohamed IS, et al. Utility of Magnetoencephalography in the Evaluation of Recurrent Seizures After Epilepsy Surgery. Epilepsia. 2007;48(11):2150-9. PubMed PMID: 17727666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of magnetoencephalography in the evaluation of recurrent seizures after epilepsy surgery. AU - Mohamed,Ismail S, AU - Otsubo,Hiroshi, AU - Ochi,Ayako, AU - Elliott,Irene, AU - Donner,Elizabeth, AU - Chuang,Sylvester, AU - Sharma,Rohit, AU - Holowka,Stephanie, AU - Rutka,James, AU - Snead,O Carter,3rd Y1 - 2007/08/28/ PY - 2007/8/31/pubmed PY - 2008/1/3/medline PY - 2007/8/31/entrez SP - 2150 EP - 9 JF - Epilepsia JO - Epilepsia VL - 48 IS - 11 N2 - PURPOSE: To study the role of magnetoencephalography (MEG) in the surgical evaluation of children with recurrent seizures after epilepsy surgery. METHODS: We studied 17 children with recurrent seizures after epilepsy surgery using interictal and ictal scalp EEG, intracranial video EEG (IVEEG), MRI, and MEG. We analyzed the location and distribution of MEG spike sources (MEGSSs) and the relationship of MEGSSs to the margins of previous resections and surgical outcome. RESULTS: Clustered MEGSSs occurred at the margins of previous resections within two contiguous gyri in 10 patients (group A), extended spatially from a margin by < or =3 cm in three patients (group B), and were remote from a resection margin by >3 cm in six patients (group C). Two patients had concomitant group A and C clusters. Thirteen patients underwent second surgeries. IVEEG was used in four patients. Six of seven patients with group A MEGSS clusters did not require IVEEG for second surgeries. Follow-up periods ranged from 0.6 to 4.3 years (mean: 2.6 years). Eleven children, including eight who became seizure-free, achieved Engel class I or II. CONCLUSION: Our data demonstrate the utility of MEG for evaluating patients with recurrent seizures after epilepsy surgery. Specific MEGSS cluster patterns delineate epileptogenic zones. Removing cluster regions adjacent to the margins of previous resections, in addition to removing recurrent lesions, achieves favorable surgical outcome. Cluster location and extent identify which patients require IVEEG, potentially eliminating IVEEG for some. Patients with remotely located clusters require IVEEG for accurate assessment and localization of the entire epileptogenic zone. SN - 0013-9580 UR - https://www.unboundmedicine.com/medline/citation/17727666/Utility_of_magnetoencephalography_in_the_evaluation_of_recurrent_seizures_after_epilepsy_surgery_ L2 - https://doi.org/10.1111/j.1528-1167.2007.01271.x DB - PRIME DP - Unbound Medicine ER -