Details

Autor(en) / Beteiligte

• Kasper, Burkhard S.
• Rössler, Karl
• Hamer, Hajo M.
• Dörfler, Arnd
• Blümcke, Ingmar
• Coras, Roland
• Roesch, Julie
• Mennecke, Angelika
• Wellmer, Jörg
• Sommer, Björn
• Lorber, Bogdan
• Lang, Johannes D.
• Graf, Wolfgang
• Stefan, Hermann
• Schwab, Stefan
• Buchfelder, Michael
• Rampp, Stefan

Titel

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

Ist Teil von

• NeuroImage clinical, 2018-01, Vol.19, p.487-496

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 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. 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). 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. •Focal cortical dysplasia Type II (FCD II) is a highly epileptogenic brain lesion.•Magnetic source imaging (MSI) is able to image lesion-related epileptogenicity in FCD II.•MSI detected sources close to the lesion in 95% of patients.•Seizure outcomes were better if the MEG-marked MAP-lesion was resected.•Integrating MSI into the diagnostic and therapeutic strategy is useful in FCD II – surgery.