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From the Departments of Neurosurgery (Drs. Pataraia, Simos, Castillo, Billingsley, Sarkari, W. Maggio, Breier, and Papanicolaou), Neurology (Drs. Wheless and V. Maggio), Pediatrics (Drs. Wheless and Swank), and Pediatric Surgery (Dr. Baumgartner), Vivian L. Smith Center for Neurologic Research, University of Texas–Health Science Center at Houston.
Address correspondence and reprint requests to Dr. Ekaterina Pataraia, Department of Neurosurgery, University of Texas, Houston Medical Center, 1333 Moursund, Ste H 114, Houston, TX 77030; e-mail: epataraia1{at}uth.tmc.edu
Objective: The authors evaluated the sensitivity and selectivity of interictal magnetoencephalography (MEG) versus prolonged ictal and interictal scalp video-electroencephalography (V-EEG) in order to identify patient groups that would benefit from preoperative MEG testing.
Methods: The authors evaluated 113 consecutive patients with medically refractory epilepsy who underwent surgery. The epileptogenic region predicted by interictal and ictal V-EEG and MEG was defined in relation to the resected area as perfectly overlapping with the resected area, partially overlapping, or nonoverlapping.
Results: The sensitivity of a 30-minute interictal MEG study for detecting clinically significant epileptiform activity was 79.2%. Using MEG, we were able to localize the resected region in a greater proportion of patients (72.3%) than with noninvasive V-EEG (40%). MEG contributed to the localization of the resected region in 58.8% of the patients with a nonlocalizing V-EEG study and 72.8% of the patients for whom V-EEG only partially identified the resected zone. Overall, MEG and V-EEG results were equivalent in 32.3% of the cases, and additional localization information was obtained using MEG in 40% of the patients.
Conclusion: MEG is most useful for presurgical planning in patients who have either partially or nonlocalizing V-EEG results.
Received August 1, 2003. Accepted in final form November 26, 2003.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the March 23 issue to find the title link for this article.
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