Magnetoencephalography source localization and surgical outcome in temporal lobe epilepsy
Magnetoencephalography source localization and surgical outcome in temporal lobe epilepsy
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DOI：
10.1016/j.clinph.2004.04.020
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发表时间：
2004-09-01
影响因子：
4.7
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：前瞻性研究脑磁图(MEG)在难治性颞叶癫痫(TLE)发作灶定位和手术疗效预测中的作用。方法：对26例TLE患者同时进行发作间期脑电和脑磁图(两个37导联系统)检查，并进行脑磁图来源定位。将早期模型偶极子与颅内脑电、颞叶手术切除及手术结果进行对比分析。结果：12例患者均有前水平或切向偶极子位于前下外侧颞尖皮质。2例行选择性杏仁核海马区切除术(SAH)，9例行前内侧颞叶切除术(AMTL)。除一名患者最初SAH失败外，所有患者都获得了成功的结果，但AMTL后癫痫发作消失。11例患者显示前颞叶垂直或切向斜偶极子。5名患者患有AMTL，3名患者患有SAH；所有患者的癫痫发作都消失了。以上23例患者中有5例有侵袭性脑电图，表现为中枢性癫痫发作。3例TLE患者的侧方垂直偶极子与颅内EEG一致，在颞叶新皮质切除后发作消失。结论：脑磁源分析提供了有用的定位信息，预测了手术结果，有助于计划TLE的有限手术切除。(C)2004年国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: We prospectively investigated the role of magnetoencephalography (MEG) in localizing the seizure focus and in predicting outcome to surgical resections for intractable temporal lobe epilepsy (TLE).Methods: We performed simultaneous interictal EEG and MEG recording (two 37-channel system) in 26 TLE patients followed by MEG source localization. We correlated early modeling dipoles with intracranial EEG, temporal surgical resection and surgical outcome.Results: There were 12 patients who had anterior temporal horizontal or tangential dipoles to the anterior infero-lateral temporal tip cortex. Two patients underwent selective amygdalo-hippocampectomy (SAH) and nine patients had antero-medial temporal lobectomy (AMTL). All patients had successful outcome except for one patient who initially failed SAH, but became seizure-free after AMTL. There were 11 patients who demonstrated anterior temporal vertical or tangential oblique dipoles. Five patients had AMTL and three had SAH; all became seizure free. Five of above 23 patients had invasive EEG and demonstrated mesial seizure onset. Three TLE patients had lateral vertical dipoles that were concordant with intracranial EEG and these became seizure free after temporal neocortical resections.Conclusions: MEG source analysis produces distinct source patterns that provide useful localizing information, predict surgical outcome, and may aid in planning limited surgical resection in TLE. (C) 2004 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.