Magnetoencephalographic localization of multiple seizure foci for surgical treatment of intractable frontal lobe epilepsy: Confirmation with intra-operative electrocorticography

Hiroshi Shamoto, Nobukazu Nakasato, Hiroaki Shimizu, Masaki Iwasaki, Takashi Yoshimoto

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A successfully treated case of intractable FLE, of which preoperative magnetoencephalography (MEG) provided multiple spike localization and intraoperative corticogram (ECoG) confirmed the resection area. A 22-year-old male patient, with a history of subdural abscess at the age of 14 years, had suffered frequent simple (SPSs) and complex partial seizures (CPSs) and falling attacks since the age of 16 years. Although he underwent corpus callosotomy at the age of 17 years, additional surgical treatment was considered because of intractable and more frequent SPSs and CPSs. Magnetic resonance (MR) imaging demonstrated diffuse lesions in the right frontal lobe. Although, both interictal and ictal electroencephalography (EEG) failed to show focal epileptogenic localization, interictal MEG localized several clusters over the multiple anatomical lesions in the right prefrontal and frontal opercular regions. The patient underwent right fronto-temporal craniotomy, and anterior frontal lobectomy, followed by lesionectomy of the premotor area based on the intraoperative ECoG findings. The ECoG localized frequent spike discharges over the right prefrontal, frontal operculum and premotor cortices, which showed good correspondence with the MEG findings. MEG can be a useful noninvasive method for presurgical evaluation of intractable FLE.

Original languageEnglish
Pages (from-to)417-423
Number of pages7
JournalNeurological Surgery
Volume30
Issue number4
Publication statusPublished - 2002 May 11

Keywords

  • Epilepsy surgery
  • Frontal lobe epilepsy
  • Intraoperative electrocorticography
  • MEG

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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