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Yield of repeat routine MEG recordings in clinical practice
Rafeed Alkawadri1, Richard Burgess, Cigdem Isitan
1Cleveland Clinic Epilepsy Center, 9500 Euclid Avenue, Cleveland, OH 44195, USA. mhdrafeed.alkawadri@yale.edu
Epilepsy & Behavior : E&B
|April 2, 2013
Summary
Repeat magnetoencephalography (MEG) is valuable for epilepsy patients. A second MEG scan can offer new seizure localization data, especially when initial results are inconclusive or show limited abnormalities.
Area of Science:
- Neurology
- Biophysics
Background:
- Intractable epilepsy requires precise localization of seizure onset zones for effective treatment.
- Magnetoencephalography (MEG) is a non-invasive neurophysiological tool used to identify these zones.
Purpose of the Study:
- To evaluate the diagnostic yield of repeat magnetoencephalography (MEG) in patients with intractable epilepsy.
- To identify reasons for repeat MEG and assess the impact on seizure localization.
Main Methods:
- Retrospective review of 19 patients who underwent repeat MEG between 2008-2011.
- Source localization using a single equivalent current dipole (ECD) model on interictal spikes.
- Analysis of clinical, neuroimaging, and concurrent EEG/MEG data.
Main Results:
- Repeat MEG provided new localizing findings in 11 out of 19 patients (58%).
- This was particularly useful in 6 patients with initially negative or rare interictal discharges.
- Lobar concordance was high (85%) in patients with positive findings on both studies.
Conclusions:
- Repeat MEG can yield significant new localization data in intractable epilepsy cases.
- It is beneficial when initial studies are negative, show rare discharges, or have uncertain findings.
- This supports the utility of repeat MEG in optimizing surgical planning for epilepsy.
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