Ictal magnetoencephalography in temporal and extratemporal lobe epilepsy
Ictal magnetoencephalography in temporal and extratemporal lobe epilepsy
复制标题
DOI：
10.1046/j.1528-1157.2003.14303.x
复制
发表时间：
2003-10-01
期刊：
影响因子：
5.6
通讯作者：
Aminoff, MJ
中科院分区：
文献类型：
--
作者：
Assaf, BA;Karkar, KM;Aminoff, MJ
目的：探讨难治性颞叶癫痫(TLE)和颞外癫痫(ETE)患者发作期脑磁图(MEG)的视觉模式和来源定位。方法：对2例TLE和5例ETE患者同时进行棘波和癫痫的脑电和脑磁图检查。头皮脑电记录来自21个通道(10-20国际系统)，而脑磁图是从两个37通道传感器记录的。我们比较了发作期脑电和脑磁图的发作、频率和演变，并进行了发作期棘波和发作期早期放电的脑磁偶极子定位和脑磁共振成像(MRI)的共同登记偶极子。结果：发作期脑磁图对两例TLE患者的癫痫发作进行了定侧，并与脑电图显示了发作期发作、发作频率和发作期演变。发作期脑磁图来源分析显示，1例患者的切线垂直偶极子位于前外侧角，另1例患者的前偶极子呈前后方向。头颅EEG显示第一例患者出现区域性内嗅性癫痫发作。两名患者在颞叶切除术后均无癫痫发作。在ETE中，发作期脑磁图显示与发作期脑电相似的视觉模式，并与发作期脑磁图的定位一致。两名患者接受了手术。两例发作期脑磁图定位均与颅内脑电一致。1例患者术后恢复良好。结论：发作期脑磁图可以显示发作期发作的频率和演变，为癫痫手术前的定位提供了有用的信息。
Purpose: We evaluated visual patterns and source localization of ictal magnetoencephalography (MEG) in patients with intractable temporal lobe epilepsy (TLE) and extratemporal epilepsy (ETE).Methods: We performed spike and seizure recording simultaneously with EEG and MEG on two patients with TLE and five patients with ETE. Scalp EEG was recorded from 21 channels (10-20 international system), whereas MEG was recorded from two 37-channel sensors. We compared ictal EEG and MEG onset, frequency, and evolution and performed MEG dipole source localization of interictal spikes and early ictal discharges and co-registered dipoles to brain magnetic resonance imaging (MRI). We correlated dipole characteristics with intracranial EEG, surgical resection, and outcome.Results: Ictal MEG lateralized seizure onset in both TLE patients and demonstrated ictal onset, frequency, and evolution in accordance with EEG. Ictal MEG source analysis revealed tangential vertical dipoles in the anterolateral angle in one patient, and anterior dipoles with anteroposterior orientation in the other. Intracranial EEG revealed regional entorhinal seizure onset in the first patient. Both patients became seizure free after temporal lobectomy. In ETE, ictal MEG demonstrated visual patterns similar to ictal EEG and had concordant localization with interictal MEG in all five patients. Two patients underwent surgery. Ictal MEG localization was concordant with intracranial EEG in both cases. One patient had successful outcome after surgery. The second patient did not improve after limited resection and multiple subpial transections.Conclusions: Ictal MEG can demonstrate ictal onset frequency and evolution and provide useful localizing information before epilepsy surgery.