Connectivity-based localization and mapping of central epilepsy semiology

Area of Science:

• Neuroscience
• Epileptology
• Neuroimaging

Background:

• Accurate preoperative anatomical hypotheses are crucial for central epilepsy management.
• Comprehensive reports correlating semiology with central epilepsy subregions are lacking.

Purpose of the Study:

• To identify semiologic subgroups in central epilepsy.
• To correlate these subgroups with specific central brain subregions.

Main Methods:

• Retrospective analysis of 21 patients with central epilepsy using stereoelectroencephalography (sEEG).
• Segmentation of the central region into 12 subregions based on the Human Brainnetome Atlas.
• Quantitative analysis of sEEG data and semiologic patterns.

Main Results:

• Three distinct patient groups based on semiologic patterns were defined.
• Observed correlations include paracentral lobule (PCL) involvement in sensory and autonomic signs, and postcentral gyrus (PoG) and precentral gyrus (PrG) involvement in motor and sensory signs.
• Early seizure spread networks were mapped, showing distinct propagation patterns based on origin within the central region.

Conclusions:

• Localizing semiology to central subregions enhances understanding of central epilepsy dynamics.
• Mapping clinical patterns to early spread networks aids in defining the range of epileptogenic anomalies preoperatively.
• Findings suggest a reevaluation of traditional somatosensory and motor sign localizations.