title: Tuberous sclerosis: localizing the epileptogenic tuber with synthetic aperture magnetometry with excess kurtosis analysis.
abstract: The hallmark of tuberous sclerosis is the presence of multiple cortical tubers. Identifying the epileptogenic tubers is difficult and often requires invasive intracranial electroencephalograph (EEG) monitoring. We report on a patient with tuberous sclerosis upon whom the novel magnetoencephalography (MEG) technique of synthetic aperture magnetometry (SAM) with excess kurtosis (g2) analysis was performed for localization of the epileptogenic tuber. Simultaneous electroencephalography (EEG) was also performed. MEG data, as analyzed by SAM(g2), were superimposed on the patient's MRIs. In the fluid attenuated inversion recovery MRIs, several tubers and subependymal nodules could be identified, with the largest tubers being located in the right frontal and left anteriotemporal regions. Despite multiple cortical lesions existing, the SAM(g2) images showed a single large tuber and surrounding epileptogenic tissue in the left temporal cortex. We suggest that MEG with SAM(g2) analysis may be clinically useful for the accurate identification of epileptogenic tubers in patients with tuberous sclerosis.
authors.affiliation: Departments of Clinical Neuroscience and Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan. leocanon2002@yahoo.com.mx
authors.forename: Leonides
authors.initials: L
authors.lastname: Canuet
authors.forename: Ryouhei
authors.initials: R
authors.lastname: Ishii
authors.forename: Masao
authors.initials: M
authors.lastname: Iwase
authors.forename: Ryu
authors.initials: R
authors.lastname: Kurimoto
authors.forename: Koji
authors.initials: K
authors.lastname: Ikezawa
authors.forename: Michiyo
authors.initials: M
authors.lastname: Azechi
authors.forename: Mari
authors.initials: M
authors.lastname: Wataya-Kaneda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D004569:Electroencephalography / Q000379:methods; D001330:Electronic Data Processing; D004827:Epilepsy / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008280:Magnetics; D015225:Magnetoencephalography / Q000379:methods*; D014402:Tuberous Sclerosis / Q000150:complications / Q000473:pathology*