Diagnostic added value of interictal magnetic source imaging in presurgical evaluation of persons with epilepsy: A prospective blinded study

2021 ◽  
Author(s):  
Manjari Tripathi ◽  
Kirandeep Kaur ◽  
Bhargavi Ramanujam ◽  
Vibhin Viswanathan ◽  
Kamal Bharti ◽  
...  
Keyword(s):  
Added Value ◽  
Presurgical Evaluation ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Magnetic Source ◽  
Blinded Study

scholarly journals Utility of magnetic source imaging in nonlesional focal epilepsy: a prospective study

2020 ◽  
Vol 48 (4) ◽  
pp. E16
Author(s):  
Ismail Sidky Mohamed ◽  
Dènahin Hinnoutondji Toffa ◽  
Manon Robert ◽  
Patrick Cossette ◽  
Arline-Aude Bérubé ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Surgical Outcome ◽  
Focal Epilepsy ◽  
Added Value ◽  
Epileptogenic Zone ◽  
Presurgical Evaluation ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Magnetic Source ◽  
Blinded Study

OBJECTIVEFor patients with nonlesional refractory focal epilepsy (NLRFE), localization of the epileptogenic zone may be more arduous than for other types of epilepsy and frequently requires information from multiple noninvasive presurgical modalities and intracranial EEG (icEEG). In this prospective, blinded study, the authors assessed the clinical added value of magnetic source imaging (MSI) in the presurgical evaluation of patients with NLRFE.METHODSThis study prospectively included 57 consecutive patients with NLRFE who were considered for epilepsy surgery. All patients underwent noninvasive presurgical evaluation and then MSI. To determine the surgical plan, discussion of the results of the presurgical evaluation was first undertaken while discussion participants were blinded to the MSI results. MSI results were then presented. MSI influence on the initial management plan was assessed.RESULTSMSI results influenced patient management in 32 patients. MSI results led to the following changes in surgical strategy in 14 patients (25%): allowing direct surgery in 6 patients through facilitating the detection of subtle cortical dysplasia in 4 patients and providing additional concordant diagnostic information to other presurgical workup in another 2 patients; rejection of surgery in 3 patients originally deemed surgical candidates; change of plan from direct surgery to icEEG in 2 patients; and allowing icEEG in 3 patients deemed not surgical candidates. MSI results led to changed electrode locations and contact numbers in another 18 patients. Epilepsy surgery was performed in 26 patients influenced by MSI results and good surgical outcome was achieved in 21 patients.CONCLUSIONSThis prospective, blinded study showed that information provided by MSI allows more informed icEEG planning and surgical outcome in a significant percentage of patients with NLRFE and should be included in the presurgical workup in those patients.

Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy

2012 ◽  
Vol 83 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Xavier De Tiège ◽  
Evelien Carrette ◽  
Benjamin Legros ◽  
Kristl Vonck ◽  
Marc Op de beeck ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Added Value ◽  
Presurgical Evaluation ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Magnetic Source

Accuracy of diffusion tensor magnetic resonance imaging tractography assessed using intraoperative subcortical stimulation mapping and magnetic source imaging

2007 ◽  
Vol 107 (3) ◽  
pp. 488-494 ◽  
Author(s):  
Jeffrey I. Berman ◽  
Mitchel S. Berger ◽  
Sungwon Chung ◽  
Srikantan S. Nagarajan ◽  
Roland G. Henry
Keyword(s):  
White Matter ◽  
Magnetic Resonance ◽  
Diffusion Tensor ◽  
Fiber Tracking ◽  
Bipolar Electrode ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Motor Pathway ◽  
Magnetic Source ◽  
Subcortical Stimulation

Object Resecting brain tumors involves the risk of damaging the descending motor pathway. Diffusion tensor (DT)–imaged fiber tracking is a noninvasive magnetic resonance (MR) technique that can delineate the subcortical course of the motor pathway. The goal of this study was to use intraoperative subcortical stimulation mapping of the motor tract and magnetic source imaging to validate the utility of DT-imaged fiber tracking as a tool for presurgical planning. Methods Diffusion tensor-imaged fiber tracks of the motor tract were generated preoperatively in nine patients with gliomas. A mask of the resultant fiber tracks was overlaid on high-resolution T1- and T2-weighted anatomical MR images and used for stereotactic surgical navigation. Magnetic source imaging was performed in seven of the patients to identify functional somatosensory cortices. During resection, subcortical stimulation mapping of the motor pathway was performed within the white matter using a bipolar electrode. Results A total of 16 subcortical motor stimulations were stereotactically identified in nine patients. The mean distance between the stimulation sites and the DT-imaged fiber tracks was 8.7 ±3.1 mm (±standard deviation). The measured distance between subcortical stimulation sites and DT-imaged fiber tracks combines tracking technique errors and all errors encountered with stereotactic navigation. Conclusions Fiber tracks delineated using DT imaging can be used to identify the motor tract in deep white matter and define a safety margin around the tract.

scholarly journals Magnetic source imaging for the surgical evaluation of electroencephalography-confirmed secondary bilateral synchrony in intractable epilepsy

2009 ◽  
Vol 111 (6) ◽  
pp. 1248-1256 ◽  
Author(s):  
Edward F. Chang ◽  
Srikantan S. Nagarajan ◽  
Mary Mantle ◽  
Nicholas M. Barbaro ◽  
Heidi E. Kirsch
Keyword(s):  
Mr Imaging ◽  
Intractable Epilepsy ◽  
Focal Lesion ◽  
Seizure Type ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Ms Imaging ◽  
Epileptiform Discharges ◽  
Magnetic Source ◽  
Imaging Results

Object Routine scalp electroencephalography (EEG) cannot always distinguish whether generalized epileptiform discharges are the result of primary bilateral synchrony or secondary bilateral synchrony (SBS) from a focal origin; this is an important distinction because the latter may be amenable to resection. Whole-head magnetoencephalography (MEG) has superior spatial resolution compared with traditional EEG, and can potentially elucidate seizure foci in challenging epilepsy cases in which patients are undergoing evaluation for surgery. Methods Sixteen patients with medically intractable epilepsy in whom SBS was suspected were referred for magnetic source (MS) imaging. All patients had bilateral, synchronous, widespread, and most often generalized spike-wave discharges on scalp EEG studies, plus some other clinical (for example, seizure semiology) or MR imaging feature (for example, focal lesion) suggesting focal onset and hence possible surgical candidacy. The MS imaging modality is the combination of whole-head MEG and parametric reconstruction of corresponding electrical brain sources. An MEG and simultaneous EEG studies were recorded with a 275-channel whole-head system. Single-equivalent current dipoles were estimated from the MEG data, and dipole locations and orientations were superimposed on patients' MR images. Results The MS imaging studies revealed focal dipole clusters in 12 (75%) of the 16 patients, of which a single dipole cluster was identified in 7 patients (44%). Patient age, seizure type, duration of disease, video-EEG telemetry, and MR imaging results were analyzed to determine factors predictive of having clusters revealed on MS imaging. Of these factors, only focal MR imaging anatomical abnormalities were associated with dipole clusters (chi-square test, p = 0.03). Selective resections (including the dipole cluster) in 7 (87%) of 8 patients resulted in seizure-free or rare seizure outcomes (Engel Classes I and II). Conclusions Magnetic source imaging may provide noninvasive anatomical and neurophysiological confirmation of localization in patients in whom there is a suspicion of SBS (based on clinical or MR imaging data), especially in those with an anatomical lesion. Identification of a focal seizure origin has significant implications for both resective and nonresective treatment of intractable epilepsy.

scholarly journals Detection and Magnetic Source Imaging of Fast Oscillations (40–160 Hz) Recorded with Magnetoencephalography in Focal Epilepsy Patients

2016 ◽  
Vol 29 (2) ◽  
pp. 218-231 ◽  
Author(s):  
Nicolás von Ellenrieder ◽  
Giovanni Pellegrino ◽  
Tanguy Hedrich ◽  
Jean Gotman ◽  
Jean-Marc Lina ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Magnetic Source ◽  
Fast Oscillations

Magnetic source imaging (MSI) in children with neocortical epilepsy: Surgical outcome association with 3D post-resection analysis

2013 ◽  
Vol 106 (1-2) ◽  
pp. 164-172 ◽  
Author(s):  
Hyunmi Kim ◽  
Pongkiat Kankirawatana ◽  
Jeff Killen ◽  
Allan Harrison ◽  
Ahyuda Oh ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Source Imaging ◽  
Magnetic Source Imaging ◽  
Magnetic Source ◽  
Neocortical Epilepsy
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