Imag(in)ing seizure propagation: MEG-guided interpretation of epileptic activity from a deep source

Zhong I. Wang, Kazutaka Jin, Yosuke Kakisaka, John C. Mosher, William E. Bingaman, Prakash Kotagal, Richard C. Burgess, Imad M. Najm, Andreas V. Alexopoulos

研究成果: Article査読

19 被引用数 (Scopus)

抄録

Identification and accurate localization of seizure foci is vital in patients with medically-intractable focal epilepsy, who may be candidates for potentially curative resective epilepsy surgery. We present a patient with difficult-to-control seizures associated with an occult focal cortical dysplasia residing within the deeper left parietal operculum and underlying posterior insula, which was not detected by conventional MRI analysis. Propagated activities from this deeper generator produced misleading EEG patterns both on surface and subdural electrode recordings suggesting initial activation of the perirolandic and mesial frontal regions. However, careful spatio-temporal analysis of stereotyped interictal activities recorded during MEG, using sequential dipole modeling, revealed a consistent pattern of epileptic propagation originating from the deeper source and propagating within few milliseconds to the dorsal convexity. In this instance, careful dissection of noninvasive investigations (interictal MEG along with ictal SPECT findings) allowed clinicians to dismiss the inaccurate and misleading findings of the traditional "gold-standard" intracranial EEG. In fact, this multimodal noninvasive approach uncovered a subtle dysplastic lesion, resection of which rendered the patient seizure-free. This case highlights the potential benefits of dynamic analysis of interictal MEG in the appropriate clinical context. Pathways of interictal spike propagation may help elucidate essential neural networks underlying focal epilepsy.

本文言語English
ページ(範囲)2797-2801
ページ数5
ジャーナルHuman Brain Mapping
33
12
DOI
出版ステータスPublished - 2012 12

ASJC Scopus subject areas

  • 解剖学
  • 放射線技術および超音波技術
  • 放射線学、核医学およびイメージング
  • 神経学
  • 臨床神経学

フィンガープリント

「Imag(in)ing seizure propagation: MEG-guided interpretation of epileptic activity from a deep source」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル