Magnetoencephalography in Pediatric Lesional Epilepsy Surgery

Kim, Hunmin; Lim, Byung Chan; Jeong, Woorim; Kim, June Sic; Chae, Jong‐Hee; Kim, Ki Joong; Chung, Chun Kee; Hwang, Yong Seung

doi:10.3346/jkms.2012.27.6.668

Cited by 10 publications

(4 citation statements)

References 21 publications

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“…MEG spike source clusters were closely related to the epileptogenic zone 33) and this should be confirmed with seizure control after a successful surgery. These findings were also observed in Korean patients with lesional epilepsy surgery 34) . Lobar concordance was 100% with MEG spike source clusters and these clusters were located at the lesion or in the vicinity in most of the cases ( Fig.…”

Section: Application Of Meg In Pediatric Epilepsysupporting

confidence: 67%

Magnetoencephalography in pediatric epilepsy

Kim

Chung

2013

Korean J Pediatr

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Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data of MEG and electroencephalography are not mutually exclusive and it is recorded simultaneously and interpreted together. MEG has been shown to be useful in detecting the irritative zone in both lesional and nonlesional epilepsy surgery. It has provided valuable and additive information regarding the lesion that should be resected in epilepsy surgery. Better outcomes in epilepsy surgery were related to the localization of the irritative zone with MEG. The value of MEG in epilepsy surgery is recruiting more patients to epilepsy surgery and providing critical information for surgical planning. MEG cortical mapping is helpful in younger pediatric patients, especially when the epileptogenic zone is close to the eloquent cortex. MEG is also used in both basic and clinical research of epilepsy other than surgery. MEG is a valuable diagnostic modality for diagnosis and treatment, as well as research in epilepsy.

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Section: Application Of Meg In Pediatric Epilepsysupporting

confidence: 67%

Magnetoencephalography in pediatric epilepsy

Kim

Chung

2013

Korean J Pediatr

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“…Magnetoencephalography is a sophisticated medical device which can detect subtle brain activity and the epileptogenicity of lesions. Its clinical role for detecting epileptogenicity preoperatively may replace that of CSDER in those cases with visible lesions on neuroimaging because MEG, unlike CSDER, is noninvasive [20–23] . In Case 1, MEG was used instead of CSDER.…”

Section: Discussionmentioning

confidence: 99%

Epilepsy surgery of dysembryoplastic neuroepithelial tumors using advanced multitechnologies with combined neuroimaging and electrophysiological examinations

Shinoda¹,

Yokoyama²,

Miwa³

et al. 2013

Epilepsy & Behavior Case Reports

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PurposeWe report three cases of dysembryoplastic neuroepithelial tumor (DNT) with intractable epilepsy which were successfully treated with surgery.MethodsIn all cases, technology beyond the routine workup was critical to success. Preoperative magnetic resonance imaging, 18F-fluorodeoxyglucose positron emission tomography (PET), 11C-methionine-PET, interictal electroencephalography, and intraoperative electrocorticography were utilized in all patients. In individual cases, however, additional procedures such as preoperative magnetoencephalography (Case 1), diffusion tensor fiber tractography, a neuronavigation system, and intraoperative somatosensory-evoked potential (Case 2), and fiber tractography and the neuronavigation-guided fence-post tube technique (Case 3) were instrumental.ResultsIn all the cases, the objectives of total tumor resection, resection of the epileptogenic zone, and complete postoperative seizure control and the avoidance of surgical complications were achieved.ConclusionsDysembryoplastic neuroepithelial tumor is commonly associated with medically intractable epilepsy, and surgery is frequently utilized. As DNT may arise in any supratentorial and intracortical locations within or near the critical area of the brain, meticulous surgical strategies are necessary to avoid neurological deficits. We demonstrate in the following three cases how adjunct procedures using advanced multitechnologies with neuroimaging and electrophysiological examinations may be utilized to ensure success in DNT surgery.

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“…In cases with well-defined lesions located in nonvital brain areas, epilepsy generating brain regions can be completely removed with postoperative seizure freedom reaching as high as 70 to 90%. 123,124 In such cases, the seizure onset zone may be adjacent to the lesion, and MEG studies can provide this information for surgical planning. 16 Conversely nonlesional, multilesional, or apparently nonfocal epilepsy (focal seizure semiology but nonfocal ictal onset on routine EEG) is much more difficult to treat surgically, as the origin and spatial extent of a propagating epilepsy network needs to be identified often with multimodal evaluations.…”

Section: Recent Clinical Examplesmentioning

confidence: 99%

Magnetoencephalography for Clinical Pediatrics: Recent Advances in Hardware, Methods, and Clinical Applications

et al. 2015

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Advancements in magnetoencephalography (MEG) present new opportunities for clinical pediatric centers faced with the challenge of offering a sensitive diagnostic evaluation for epilepsy in infants and young children. A noninvasive brain imaging method, which measures the magnetic fields generated by the electrical activity of the human brain, MEG provides significant advantages that make it particularly suitable for pediatric use. First, patient preparation is quick and easy and, unlike functional magnetic resonance imaging/magnetic resonance imaging, operates silently. As such, brain activity can be measured in a much more child-friendly environment. Second, although similar to electroencephalography in providing millisecond temporal resolution of neural activity, MEG offers advantages over electroencephalography in superior spatial resolution given the sensitivity of MEG to intracellular neural currents and the relative ?transparency? of magnetic fields to biological tissues. Finally, when combined with magnetic resonance imaging, MEG data contribute unique information to the evaluation and localization of foci beyond that obtained with other neuroimaging technologies. As an example, the utility of MEG has been shown in determining irritative onset zones associated with epileptiform activity and for the functional mapping of nearby eloquent areas. This article reviews MEG theory along with new methods and technological advances, which result in improvements in pediatric epilepsy care. After a brief introduction to MEG technology, recent hardware developments (optimized for pediatrics), improved signal processing methods, and technological developments are reviewed. Next, two clinical case studies are presented to provide examples of MEG source localization methods applied to identify epileptogenic foci in pediatrics and compare established and recently developed analysis methods. We conclude that MEG is a unique and powerful imaging method for epilepsy treatment and patient care, increasingly a focal point in medical settings aiming to excel in the treatment of epilepsy both for diagnostics and surgical outcomes with near-future pediatric MEG system also providing optimal clinical assessments in infants and young children.

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Magnetoencephalography in Pediatric Lesional Epilepsy Surgery

Cited by 10 publications

References 21 publications

Magnetoencephalography in pediatric epilepsy

Magnetoencephalography in pediatric epilepsy

Epilepsy surgery of dysembryoplastic neuroepithelial tumors using advanced multitechnologies with combined neuroimaging and electrophysiological examinations

Magnetoencephalography for Clinical Pediatrics: Recent Advances in Hardware, Methods, and Clinical Applications

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