Utility of Magnetoencephalography in the Evaluation of Recurrent Seizures after Epilepsy Surgery

作者：Ismail Mohamed, Hiroshi Otsubo, Ayako Ochi, Irene Elliott, Elizabeth Donner, Sylvester H. Chuang, Rohit Sharma, Stephanie Holowka, James T. Rutka, O. Carter Snead · 发表于：Epilepsia · 年份：2007 · DOI：10.1111/j.1528-1167.2007.01271.x · 被引用次数：57 · 研究领域：Epilepsy research and treatment、Functional Brain Connectivity Studies、Advanced MRI Techniques and Applications

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 id...