Clinical significance of ictal magnetoencephalography in patients undergoing epilepsy surgery
- PMID: 36443170
- DOI: 10.1016/j.clinph.2022.10.005
Clinical significance of ictal magnetoencephalography in patients undergoing epilepsy surgery
Abstract
Objective: The significance of ictal magnetoencephalography (MEG) is not well appreciated. We evaluated the relationships between ictal MEG, MRI, intracranial electroencephalography (ICEEG), surgery and postoperative seizure outcome.
Methods: A total of 45 patients (46 cases) with ictal MEG who underwent epilepsy surgery was included. We examined the localization of each modality, surgical resection area and seizure freedom after surgery.
Results: Twenty-one (45.7%) out of 46 cases were seizure-free at more than 6 months follow-up. Median duration of postoperative follow-up was 16.5 months. The patients in whom ictal, interictal single equivalent current dipole (SECD) and MRI lesion localization were completely included in the resection had a higher chance of being seizure-free significantly (p < 0.05). Concordance between ictal and interictal SECD localizations was significantly associated with seizure-freedom. Concordance between MRI lesion and ictal SECD, concordance between ictal ICEEG and ictal and interictal SECD, as well as concordance between ictal ICEEG and MRI lesion were significantly associated with seizure freedom.
Conclusions: Ictal MEG can contribute useful information for delineating the resection area in epilepsy surgery.
Significance: Resection should include ictal, interictal SECDs and MRI lesion localization, when feasible. Concordant ictal and interictal SECDs on MEG can be a favorable predictor of seizure freedom.
Keywords: Epilepsy surgery; Epileptogenic zone; Ictal magnetoencephalography; Intracranial electroencephalography; Seizure free; Seizure outcome; Stereo-electroencephalography.
Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Conflicts of interest The authors report no competing interests.
Comment in
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Epilepsy highlight: Ictal MEG in epilepsy surgery candidates - Results from largest cohort.Clin Neurophysiol. 2023 Jan;145:98-99. doi: 10.1016/j.clinph.2022.11.003. Epub 2022 Nov 15. Clin Neurophysiol. 2023. PMID: 36435692 No abstract available.
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