Multimodal non-invasive evaluation in MRI-negative epilepsy patients

Area of Science:

• Neurology
• Neurosurgery
• Medical Imaging

Background:

• Presurgical evaluation for epilepsy is difficult in patients with normal MRI scans.
• Non-invasive methods are crucial for economic and accessible identification of the epileptogenic zone.

Purpose of the Study:

• To analyze the localization value of non-invasive methods in MRI-negative epilepsy patients.
• To determine the association between non-invasive imaging results and epilepsy surgery outcomes.

Main Methods:

• Included 86 epilepsy patients with negative MRI results.
• Utilized Morphometric Analysis Program (MAP) for MRI post-processing.
• Analyzed magnetoencephalography (MEG) and scalp electroencephalogram (EEG) data.
• Correlated imaging findings with seizure outcomes post-surgery.

Main Results:

• Complete resection of MAP-positive or MEG-positive regions correlated with seizure freedom.
• Co-localization by MAP and MEG showed a significant association with seizure freedom (p=0.006).
• Scalp EEG lateralization and localization did not show a statistical association with surgical outcomes.

Conclusions:

• Scalp EEG has limited value in presurgical localization and predicting seizure outcomes.
• Combining MAP and MEG enhances the localization of epileptogenic lesions.
• Integrated MAP and MEG approaches positively associate with seizure-free outcomes in epilepsy surgery.