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Magnetoencephalography in pediatric lesional epilepsy surgery.

Kim H, Lim BC, Jeong W, Kim JS, Chae JH, Kim KJ, Chung CK, Hwang YS, Hwang H - J. Korean Med. Sci. (2012)

Bottom Line: Among the patients with clustered spike sources near the lesion, further extensions (three patients) and distal scatters (three patients) were also observed.MEG spike sources were well lateralized and localized even in two patients without focal epileptiform discharges in the interictal scalp electroencephalography.Ten patients (77%) achieved Engel class I postsurgical seizure outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
This study was performed to assess the usefulness of magnetoencephalography (MEG) as a presurgical evaluation modality in Korean pediatric patients with lesional localization-related epilepsy. The medical records and MEG findings of 13 pediatric patients (6 boys and 7 girls) with localization-related epilepsy, who underwent epilepsy surgery at Seoul National University Children's Hospital, were retrospectively reviewed. The hemispheric concordance rate was 100% (13/13 patients). The lobar or regional concordance rate was 77% (10/13 patients). In most cases, the MEG spike sources were clustered in the proximity of the lesion, either at one side of the margin (nine patients) or around the lesion (one patient); clustered spike sources were distant from the lesion in one patient. Among the patients with clustered spike sources near the lesion, further extensions (three patients) and distal scatters (three patients) were also observed. MEG spike sources were well lateralized and localized even in two patients without focal epileptiform discharges in the interictal scalp electroencephalography. Ten patients (77%) achieved Engel class I postsurgical seizure outcome. It is suggested that MEG is a safe and useful presurgical evaluation modality in pediatric patients with lesion localization-related epilepsy.

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Related in: MedlinePlus

MEG spike sources clustered around the lesion and scattered in patient 12. (A-C) Axial, sagittal, and coronal contrast-enhanced T1-weighted brain magnetic resonance imaging (MRI) show clusters and distant scatters (overlaid on a single brain MRI image). (D) MEG spike sources presented in an imaginary three-dimensional plane show the distribution of MEG spike sources of clusters and scatters. R, right; L, left; H, head; F, foot; AL, anterior left; PR, posterior right; A, anterior; P, posterior.
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Figure 2: MEG spike sources clustered around the lesion and scattered in patient 12. (A-C) Axial, sagittal, and coronal contrast-enhanced T1-weighted brain magnetic resonance imaging (MRI) show clusters and distant scatters (overlaid on a single brain MRI image). (D) MEG spike sources presented in an imaginary three-dimensional plane show the distribution of MEG spike sources of clusters and scatters. R, right; L, left; H, head; F, foot; AL, anterior left; PR, posterior right; A, anterior; P, posterior.

Mentions: MEG spike source clusters were observed in 11 patients, and these clusters were located in the proximity of the lesion in 10 patients. In most patients, the MEG spike sources were located on the margin of the lesion: superior (patients 4, 5, and 6), lateral (patients 1, 7, and 8), and superior and lateral (patients 10, 11, and 12). In patient 2, the spike sources were located around the lesion (Fig. 1). Among these patients, distant scatters were also identified in the contralateral hemisphere in two patients and ipsilateral hemisphere in one patient (Fig. 2). The MEG spike source cluster was distant from the lesion in patient 3. In the two patients without clusters, the MEG spike sources were scattered in both hemispheres.


Magnetoencephalography in pediatric lesional epilepsy surgery.

Kim H, Lim BC, Jeong W, Kim JS, Chae JH, Kim KJ, Chung CK, Hwang YS, Hwang H - J. Korean Med. Sci. (2012)

MEG spike sources clustered around the lesion and scattered in patient 12. (A-C) Axial, sagittal, and coronal contrast-enhanced T1-weighted brain magnetic resonance imaging (MRI) show clusters and distant scatters (overlaid on a single brain MRI image). (D) MEG spike sources presented in an imaginary three-dimensional plane show the distribution of MEG spike sources of clusters and scatters. R, right; L, left; H, head; F, foot; AL, anterior left; PR, posterior right; A, anterior; P, posterior.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369454&req=5

Figure 2: MEG spike sources clustered around the lesion and scattered in patient 12. (A-C) Axial, sagittal, and coronal contrast-enhanced T1-weighted brain magnetic resonance imaging (MRI) show clusters and distant scatters (overlaid on a single brain MRI image). (D) MEG spike sources presented in an imaginary three-dimensional plane show the distribution of MEG spike sources of clusters and scatters. R, right; L, left; H, head; F, foot; AL, anterior left; PR, posterior right; A, anterior; P, posterior.
Mentions: MEG spike source clusters were observed in 11 patients, and these clusters were located in the proximity of the lesion in 10 patients. In most patients, the MEG spike sources were located on the margin of the lesion: superior (patients 4, 5, and 6), lateral (patients 1, 7, and 8), and superior and lateral (patients 10, 11, and 12). In patient 2, the spike sources were located around the lesion (Fig. 1). Among these patients, distant scatters were also identified in the contralateral hemisphere in two patients and ipsilateral hemisphere in one patient (Fig. 2). The MEG spike source cluster was distant from the lesion in patient 3. In the two patients without clusters, the MEG spike sources were scattered in both hemispheres.

Bottom Line: Among the patients with clustered spike sources near the lesion, further extensions (three patients) and distal scatters (three patients) were also observed.MEG spike sources were well lateralized and localized even in two patients without focal epileptiform discharges in the interictal scalp electroencephalography.Ten patients (77%) achieved Engel class I postsurgical seizure outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
This study was performed to assess the usefulness of magnetoencephalography (MEG) as a presurgical evaluation modality in Korean pediatric patients with lesional localization-related epilepsy. The medical records and MEG findings of 13 pediatric patients (6 boys and 7 girls) with localization-related epilepsy, who underwent epilepsy surgery at Seoul National University Children's Hospital, were retrospectively reviewed. The hemispheric concordance rate was 100% (13/13 patients). The lobar or regional concordance rate was 77% (10/13 patients). In most cases, the MEG spike sources were clustered in the proximity of the lesion, either at one side of the margin (nine patients) or around the lesion (one patient); clustered spike sources were distant from the lesion in one patient. Among the patients with clustered spike sources near the lesion, further extensions (three patients) and distal scatters (three patients) were also observed. MEG spike sources were well lateralized and localized even in two patients without focal epileptiform discharges in the interictal scalp electroencephalography. Ten patients (77%) achieved Engel class I postsurgical seizure outcome. It is suggested that MEG is a safe and useful presurgical evaluation modality in pediatric patients with lesion localization-related epilepsy.

Show MeSH
Related in: MedlinePlus