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Magnetoencephalography in Patients with Tuberous Sclerosis and Localization‐related Epilepsy

Purpose: To clarify the usefulness of magnetoencephalography (MEG) for diagnosis of the spatial relations between spike foci and suspicious epileptogenic tubers on MRI in patients with tuberous sclerosis (TS) and to compare MEG spike foci with single‐photon emission computed tomography (SPECT) findi...

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Published in:Epilepsia (Copenhagen) 2006-06, Vol.47 (6), p.991-997
Main Authors: Kamimura, Takanori, Tohyama, Jun, Oishi, Makoto, Akasaka, Noriyuki, Kanazawa, Osamu, Sasagawa, Mutsuo, Kato, Mitsuhiro, Ohno, Kousaku, Masuda, Hiroshi, Kameyama, Shigeki, Uchiyama, Makoto
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container_title Epilepsia (Copenhagen)
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creator Kamimura, Takanori
Tohyama, Jun
Oishi, Makoto
Akasaka, Noriyuki
Kanazawa, Osamu
Sasagawa, Mutsuo
Kato, Mitsuhiro
Ohno, Kousaku
Masuda, Hiroshi
Kameyama, Shigeki
Uchiyama, Makoto
description Purpose: To clarify the usefulness of magnetoencephalography (MEG) for diagnosis of the spatial relations between spike foci and suspicious epileptogenic tubers on MRI in patients with tuberous sclerosis (TS) and to compare MEG spike foci with single‐photon emission computed tomography (SPECT) findings. Methods: We analyzed magnetic fields of epileptic spike discharges in 15 patients with TS and localization‐related epilepsy (LRE) by using MEG (a whole‐head 204‐channel magnetometer system). We investigated the spatial relation between the equivalent current dipoles (ECDs) of interictal spike discharges and visible cortical tubers on MRI. We also compared results of MEG and MRI with SPECT findings. Results: MEG detected a cluster of ECDs around one cortical tuber in six of 15 patients and clusters of ECDs around two cortical tubers in five patients. Interictal SPECT was disappointing in detection of epileptic foci in TS. However, MEG spike foci showed spatial consistency with ictal hyperperfusion areas in two patients. Three patients with single ECD clusters underwent surgical treatment: two have been seizure free, and one has obtained seizure reduction of >90%. Conclusions: ECDs were located around visible tuber nodules. MEG enabled precise localization of the epileptic foci and provided crucial information for surgical treatment in patients with TS and partial epilepsy. TS patients showing a single ECD cluster on MEG may be appropriate candidates for surgical treatment.
doi_str_mv 10.1111/j.1528-1167.2006.00511.x
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Methods: We analyzed magnetic fields of epileptic spike discharges in 15 patients with TS and localization‐related epilepsy (LRE) by using MEG (a whole‐head 204‐channel magnetometer system). We investigated the spatial relation between the equivalent current dipoles (ECDs) of interictal spike discharges and visible cortical tubers on MRI. We also compared results of MEG and MRI with SPECT findings. Results: MEG detected a cluster of ECDs around one cortical tuber in six of 15 patients and clusters of ECDs around two cortical tubers in five patients. Interictal SPECT was disappointing in detection of epileptic foci in TS. However, MEG spike foci showed spatial consistency with ictal hyperperfusion areas in two patients. Three patients with single ECD clusters underwent surgical treatment: two have been seizure free, and one has obtained seizure reduction of &gt;90%. Conclusions: ECDs were located around visible tuber nodules. MEG enabled precise localization of the epileptic foci and provided crucial information for surgical treatment in patients with TS and partial epilepsy. TS patients showing a single ECD cluster on MEG may be appropriate candidates for surgical treatment.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/j.1528-1167.2006.00511.x</identifier><identifier>PMID: 16822245</identifier><identifier>CODEN: EPILAK</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adolescent ; Adult ; Anticonvulsants. Antiepileptics. Antiparkinson agents ; Biological and medical sciences ; Brain Mapping - methods ; Cerebral Cortex - physiopathology ; Child ; Child, Preschool ; Comorbidity ; Epilepsies, Partial - diagnosis ; Epilepsies, Partial - physiopathology ; Epilepsies, Partial - surgery ; Epilepsy, Temporal Lobe - diagnosis ; Epilepsy, Temporal Lobe - physiopathology ; Epilepsy, Temporal Lobe - surgery ; Epileptic focus ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Magnetic Resonance Imaging - statistics &amp; numerical data ; Magnetoencephalography ; Magnetoencephalography - statistics &amp; numerical data ; Male ; Malformations of the nervous system ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pharmacology. 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Methods: We analyzed magnetic fields of epileptic spike discharges in 15 patients with TS and localization‐related epilepsy (LRE) by using MEG (a whole‐head 204‐channel magnetometer system). We investigated the spatial relation between the equivalent current dipoles (ECDs) of interictal spike discharges and visible cortical tubers on MRI. We also compared results of MEG and MRI with SPECT findings. Results: MEG detected a cluster of ECDs around one cortical tuber in six of 15 patients and clusters of ECDs around two cortical tubers in five patients. Interictal SPECT was disappointing in detection of epileptic foci in TS. However, MEG spike foci showed spatial consistency with ictal hyperperfusion areas in two patients. Three patients with single ECD clusters underwent surgical treatment: two have been seizure free, and one has obtained seizure reduction of &gt;90%. Conclusions: ECDs were located around visible tuber nodules. MEG enabled precise localization of the epileptic foci and provided crucial information for surgical treatment in patients with TS and partial epilepsy. TS patients showing a single ECD cluster on MEG may be appropriate candidates for surgical treatment.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>16822245</pmid><doi>10.1111/j.1528-1167.2006.00511.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Brain Mapping - methods
Cerebral Cortex - physiopathology
Child
Child, Preschool
Comorbidity
Epilepsies, Partial - diagnosis
Epilepsies, Partial - physiopathology
Epilepsies, Partial - surgery
Epilepsy, Temporal Lobe - diagnosis
Epilepsy, Temporal Lobe - physiopathology
Epilepsy, Temporal Lobe - surgery
Epileptic focus
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Magnetic Resonance Imaging - statistics & numerical data
Magnetoencephalography
Magnetoencephalography - statistics & numerical data
Male
Malformations of the nervous system
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Pharmacology. Drug treatments
SPECT
Symptomatic localization‐related epilepsy
Temporal Lobe - physiopathology
Temporal Lobe - surgery
Tomography, Emission-Computed, Single-Photon - statistics & numerical data
Tuberous sclerosis
Tuberous Sclerosis - diagnosis
Tuberous Sclerosis - physiopathology
Tuberous Sclerosis - surgery
title Magnetoencephalography in Patients with Tuberous Sclerosis and Localization‐related Epilepsy
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