TY - JOUR
T1 - Magnetoencephalography in fronto-parietal opercular epilepsy
AU - Kakisaka, Yosuke
AU - Iwasaki, Masaki
AU - Alexopoulos, Andreas V.
AU - Enatsu, Rei
AU - Jin, Kazutaka
AU - Wang, Zhong I.
AU - Mosher, John C.
AU - Dubarry, Anne Sophie
AU - Nair, Dileep R.
AU - Burgess, Richard C.
N1 - Funding Information:
This work was supported in part by the National Institutes of Health under grants R01-EB009048 and R01-NS074980 , and by the Epilepsy Center of the Cleveland Clinic Neurological Institute . The author MI was supported by the Japan Epilepsy Research Foundation and by Grant-in-Aid for Scientific Research, Japan Society for the Promotion of Science 22791330 .
PY - 2012/11
Y1 - 2012/11
N2 - Objective: To clarify the clinical and neurophysiological profiles of fronto-parietal opercular epilepsy in which epileptic spikes are detected with magnetoencephalography (MEG) but not with scalp electroencephalography (EEG). Methods: Four patients presented with epileptic spikes localized to the fronto-parietal opercular cortex, which were only appreciated following MEG recordings. Results: In all cases, seizure semiology suggested early activation of the operculum and lower peri-rolandic cortex consistent with the somatotopic organization of this region, i.e. tingling sensation involving the throat and hemi-face or contralateral upper limb, and spasms of the neck and throat. MEG spikes were localized in the fronto-parietal operculum. Three of the four patients underwent invasive electrocorticography and/or stereo-EEG recordings, and spikes were confirmed to arise from the estimated area of MEG dipole localization. Two patients remained seizure-free for over 1 year after resection of the epileptogenic region; the other patient declined resective surgery due to proximity to the language cortex. Conclusion: This study demonstrates the usefulness of MEG in localizing spikes arising from within the fronto-parietal opercular regions, and implies that MEG may provide localizing information in patients with symptoms suggestive of opercular epilepsy, even if scalp EEG recordings fail to disclose any epileptogenic activities.
AB - Objective: To clarify the clinical and neurophysiological profiles of fronto-parietal opercular epilepsy in which epileptic spikes are detected with magnetoencephalography (MEG) but not with scalp electroencephalography (EEG). Methods: Four patients presented with epileptic spikes localized to the fronto-parietal opercular cortex, which were only appreciated following MEG recordings. Results: In all cases, seizure semiology suggested early activation of the operculum and lower peri-rolandic cortex consistent with the somatotopic organization of this region, i.e. tingling sensation involving the throat and hemi-face or contralateral upper limb, and spasms of the neck and throat. MEG spikes were localized in the fronto-parietal operculum. Three of the four patients underwent invasive electrocorticography and/or stereo-EEG recordings, and spikes were confirmed to arise from the estimated area of MEG dipole localization. Two patients remained seizure-free for over 1 year after resection of the epileptogenic region; the other patient declined resective surgery due to proximity to the language cortex. Conclusion: This study demonstrates the usefulness of MEG in localizing spikes arising from within the fronto-parietal opercular regions, and implies that MEG may provide localizing information in patients with symptoms suggestive of opercular epilepsy, even if scalp EEG recordings fail to disclose any epileptogenic activities.
KW - Electroencephalography
KW - Epilepsy
KW - Magnetoencephalography
KW - Opercular region
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U2 - 10.1016/j.eplepsyres.2012.05.003
DO - 10.1016/j.eplepsyres.2012.05.003
M3 - Article
C2 - 22658720
AN - SCOPUS:84868303738
VL - 102
SP - 71
EP - 77
JO - Journal of Epilepsy
JF - Journal of Epilepsy
SN - 0920-1211
IS - 1-2
ER -