Coregistrating magnetic source and magnetic resonance imaging for epilepsy surgery in focal cortical dysplasia

Language
en
Document Type
Article
Issue Date
2019-05-10
Issue Year
2018
Authors
Kasper, Burkhard S.
Rössler, Karl
Hamer, Hajo M.
Dörfler, Arnd
Blümcke, Ingmar
Coras, Roland
Roesch, Julie
Mennecke, Angelika
Wellmer, Jörg
Sommer, Björn
Editor
Abstract

Background

Epilepsy surgery for focal cortical dysplasia type II (FCD II) offers good chances for seizure freedom, but remains a challenge with respect to lesion detection, defining the epileptogenic zone and the optimal resection strategy. Integrating results from magnetic source imaging from magnetoencephalography (MEG) with magnetic resonance imaging (MRI) including MRI postprocessing may be useful for optimizing these goals.

Methods

We here present data from 21 adult FCD II patients, investigated during a 10 year period and evaluated including magnetic source imaging. 16 patients had epilepsy surgery, i.e. histopathologically verified FCD II, and a long follow up. We present our analysis of epileptogenic zones including MEG in relation to structural data according to MRI data and relate these results to surgical outcomes.

Results

FCD II in our cohort was characterized by high MEG yield and localization accuracy and MEG showed impact on surgical success-rates. MEG source localizations were detected in 95.2% of patients and were as close as 12.3 ± 8,1 mm to the MRI-lesion. After a mean follow up of >3 years, we saw >80% Engel I outcomes, with more favourable outcomes when the MEG source was completely resected (Fishers exact test 0,033).

Conclusion

We argue for a high value of conducting a combined MEG-MRI approach in the presurgical workup and the resection strategy in patients with FCD II related epilepsy.

Journal Title
NeuroImage: Clinical
Volume
19
Citation
NeuroImage: Clinical 19 (2018): S. 487-496. <https://doi.org/10.1016/j.nicl.2018.04.034>
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