title: Toward the substitution of invasive electroencephalography in epilepsy surgery.
abstract: The authors compared the localization accuracy of interictal magnetoencephalography (MEG) with ictal and interictal invasive video electroencephalography (VEEG) in identifying the epileptogenic zone in epilepsy surgery candidates. Forty-one patients, 29 with temporal lobe epilepsy (TLE) and 12 with extratemporal lobe epilepsy (ETLE), participated. Only patients with interictal changes during the MEG recordings were included. A comparison of the accuracy of invasive VEEG and MEG seizure zone identification was based on the degree of overlap between the location of the actual surgical resection and the zone identified by each method, and the success of surgery in reducing seizure activity. No statistical differences were observed between the accuracy of invasive VEEG and MEG in determining the location of the seizure zone across TLE and ETLE cases. Invasive VEEG and MEG localization judgments were correct in 54% and 56% of the cases, respectively. Separate group analyses suggested that MEG may be less beneficial relative to invasive VEEG in ETLE than TLE cases. MEG is of statistically equivalent accuracy to invasive VEEG, despite the fact that its use has not reached optimal conditions. The authors predict the replacement of the more invasive procedure with MEG in the near future for TLE cases, subsequent to the optimization of the conditions under which preoperative MEG is performed.
authors.affiliation: Division of Clinical Neurosciences in the Department of Neurosurgery, University of Texas - Houston Health Science Center, Houston, Texas 77030, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Papanicolaou
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Pataraia
authors.forename: Rebecca
authors.initials: R
authors.lastname: Billingsley-Marshall
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Castillo
authors.forename: James W
authors.initials: JW
authors.lastname: Wheless
authors.forename: Paul
authors.initials: P
authors.lastname: Swank
authors.forename: Joshua I
authors.initials: JI
authors.lastname: Breier
authors.forename: Shirin
authors.initials: S
authors.lastname: Sarkari
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Simos
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D002648:Child; D004569:Electroencephalography / Q000379:methods*; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D015225:Magnetoencephalography / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D017063:Outcome Assessment, Health Care; D014743:Videotape Recording / Q000379:methods