A comparison of magnetoencephalography, MRI, and V-EEG in patients evaluated for epilepsy surgery

J. W. Wheless, L. J. Willmore, J. I. Breier, M. Kataki, J. R. Smith, D. W. King, K. J. Meador, Yong D Park, D. W. Loring, G. L. Clifton, J. Baumgartner, A. B. Thomas, J. E.C. Constantinou, A. C. Papanicolaou

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Abstract

Purpose: To determine the efficacy and relative contribution of several diagnostic methods [ictal and interictal scalp and intracranial EEG, magnetic resonance imaging (MRI), and magnetoencephalography (MEG)] in identifying the epileptogenic zone for resection. Methods: This was a prospective study using a masked comparison-to-criterion standard. Fifty-eight consecutive patients with refractory partial epilepsy from two university comprehensive epilepsy programs were studied. Patients who were evaluated for and underwent epilepsy surgery were recruited. The main outcome measure was the efficacy of each diagnostic method to identify the resected epileptogenic zone, when referenced to surgical outcome. Results: MEG (52%) was second only to ictal intracranial V-EEG in predicting the epileptogenic zone for the entire group of patients who had an excellent surgical outcome (seizure free or rare seizure). In a subanalysis, for patients who had temporal lobe surgery, this same relation was seen (MEG, 57%, ictal intracranial V-EEG, 62%). With extratemporal resection, ictal (81%) and interictal (75%) intracranial EEG were superior to MEG (44%) in predicting the surgery site in those patients with an excellent outcome. Finally, for all patients who had a good surgical outcome, MEG (52%) was better than ictal (33%) or interictal (45%) scalp VEEG in predicting the site of surgery. Conclusions: These results indicate that MEG is a very promising diagnostic method and raise the possibility that it may obviate the need for invasive EEG in some cases or reduce the length of scalp EEG evaluation in others.

Original languageEnglish (US)
Pages (from-to)931-941
Number of pages11
JournalEpilepsia
Volume40
Issue number7
DOIs
StatePublished - Jul 17 1999

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Magnetoencephalography
Electroencephalography
Epilepsy
Magnetic Resonance Imaging
Stroke
Scalp
Seizures
Partial Epilepsy
Temporal Lobe
Outcome Assessment (Health Care)
Prospective Studies
Electrocorticography

Keywords

  • Epilepsy
  • Epilepsy surgery
  • Magnetic source imaging
  • Magnetoencephalography

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Wheless, J. W., Willmore, L. J., Breier, J. I., Kataki, M., Smith, J. R., King, D. W., ... Papanicolaou, A. C. (1999). A comparison of magnetoencephalography, MRI, and V-EEG in patients evaluated for epilepsy surgery. Epilepsia, 40(7), 931-941. https://doi.org/10.1111/j.1528-1157.1999.tb00800.x

A comparison of magnetoencephalography, MRI, and V-EEG in patients evaluated for epilepsy surgery. / Wheless, J. W.; Willmore, L. J.; Breier, J. I.; Kataki, M.; Smith, J. R.; King, D. W.; Meador, K. J.; Park, Yong D; Loring, D. W.; Clifton, G. L.; Baumgartner, J.; Thomas, A. B.; Constantinou, J. E.C.; Papanicolaou, A. C.

In: Epilepsia, Vol. 40, No. 7, 17.07.1999, p. 931-941.

Research output: Contribution to journalArticle

Wheless, JW, Willmore, LJ, Breier, JI, Kataki, M, Smith, JR, King, DW, Meador, KJ, Park, YD, Loring, DW, Clifton, GL, Baumgartner, J, Thomas, AB, Constantinou, JEC & Papanicolaou, AC 1999, 'A comparison of magnetoencephalography, MRI, and V-EEG in patients evaluated for epilepsy surgery', Epilepsia, vol. 40, no. 7, pp. 931-941. https://doi.org/10.1111/j.1528-1157.1999.tb00800.x
Wheless, J. W. ; Willmore, L. J. ; Breier, J. I. ; Kataki, M. ; Smith, J. R. ; King, D. W. ; Meador, K. J. ; Park, Yong D ; Loring, D. W. ; Clifton, G. L. ; Baumgartner, J. ; Thomas, A. B. ; Constantinou, J. E.C. ; Papanicolaou, A. C. / A comparison of magnetoencephalography, MRI, and V-EEG in patients evaluated for epilepsy surgery. In: Epilepsia. 1999 ; Vol. 40, No. 7. pp. 931-941.
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abstract = "Purpose: To determine the efficacy and relative contribution of several diagnostic methods [ictal and interictal scalp and intracranial EEG, magnetic resonance imaging (MRI), and magnetoencephalography (MEG)] in identifying the epileptogenic zone for resection. Methods: This was a prospective study using a masked comparison-to-criterion standard. Fifty-eight consecutive patients with refractory partial epilepsy from two university comprehensive epilepsy programs were studied. Patients who were evaluated for and underwent epilepsy surgery were recruited. The main outcome measure was the efficacy of each diagnostic method to identify the resected epileptogenic zone, when referenced to surgical outcome. Results: MEG (52{\%}) was second only to ictal intracranial V-EEG in predicting the epileptogenic zone for the entire group of patients who had an excellent surgical outcome (seizure free or rare seizure). In a subanalysis, for patients who had temporal lobe surgery, this same relation was seen (MEG, 57{\%}, ictal intracranial V-EEG, 62{\%}). With extratemporal resection, ictal (81{\%}) and interictal (75{\%}) intracranial EEG were superior to MEG (44{\%}) in predicting the surgery site in those patients with an excellent outcome. Finally, for all patients who had a good surgical outcome, MEG (52{\%}) was better than ictal (33{\%}) or interictal (45{\%}) scalp VEEG in predicting the site of surgery. Conclusions: These results indicate that MEG is a very promising diagnostic method and raise the possibility that it may obviate the need for invasive EEG in some cases or reduce the length of scalp EEG evaluation in others.",
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AU - Wheless, J. W.

AU - Willmore, L. J.

AU - Breier, J. I.

AU - Kataki, M.

AU - Smith, J. R.

AU - King, D. W.

AU - Meador, K. J.

AU - Park, Yong D

AU - Loring, D. W.

AU - Clifton, G. L.

AU - Baumgartner, J.

AU - Thomas, A. B.

AU - Constantinou, J. E.C.

AU - Papanicolaou, A. C.

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N2 - Purpose: To determine the efficacy and relative contribution of several diagnostic methods [ictal and interictal scalp and intracranial EEG, magnetic resonance imaging (MRI), and magnetoencephalography (MEG)] in identifying the epileptogenic zone for resection. Methods: This was a prospective study using a masked comparison-to-criterion standard. Fifty-eight consecutive patients with refractory partial epilepsy from two university comprehensive epilepsy programs were studied. Patients who were evaluated for and underwent epilepsy surgery were recruited. The main outcome measure was the efficacy of each diagnostic method to identify the resected epileptogenic zone, when referenced to surgical outcome. Results: MEG (52%) was second only to ictal intracranial V-EEG in predicting the epileptogenic zone for the entire group of patients who had an excellent surgical outcome (seizure free or rare seizure). In a subanalysis, for patients who had temporal lobe surgery, this same relation was seen (MEG, 57%, ictal intracranial V-EEG, 62%). With extratemporal resection, ictal (81%) and interictal (75%) intracranial EEG were superior to MEG (44%) in predicting the surgery site in those patients with an excellent outcome. Finally, for all patients who had a good surgical outcome, MEG (52%) was better than ictal (33%) or interictal (45%) scalp VEEG in predicting the site of surgery. Conclusions: These results indicate that MEG is a very promising diagnostic method and raise the possibility that it may obviate the need for invasive EEG in some cases or reduce the length of scalp EEG evaluation in others.

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KW - Magnetoencephalography

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