Reinterpretation of magnetic resonance imaging findings with magnetoencephalography can improve the accuracy of detecting epileptogenic cortical lesions

Epilepsy Behav. 2021 Jan;114(Pt A):107516. doi: 10.1016/j.yebeh.2020.107516. Epub 2020 Dec 13.

Abstract

Objective: This study examined whether the application of magnetoencephalography (MEG) to interpret magnetic resonance imaging (MRI) findings can aid the diagnosis of intractable epilepsy caused by organic brain lesions.

Methods: This study included 51 patients with epilepsy who had MEG clusters but whose initial MRI findings were interpreted as being negative for organic lesions. Three board-certified radiologists reinterpreted the MRI findings, utilizing the MEG findings as a guide. The degree to which the reinterpretation of the imaging results identified an organic lesion was rated on a 5-point scale.

Results: Reinterpretation of the MRI data with MEG guidance helped detect an abnormality by at least one radiologist in 18 of the 51 patients (35.2%) with symptomatic localization-related epilepsy. A surgery was performed in 7 of the 51 patients, and histopathological analysis results identified focal cortical dysplasia in 5 patients (Ia: 1, IIa: 2, unknown: 2), hippocampal sclerosis in 1 patient, and dysplastic neurons/gliosis in 1 patient.

Conclusions: The results of this study highlight the potential diagnostic applications of MEG to detect organic epileptogenic lesions, particularly when radiological visualization is difficult with MRI alone.

Keywords: Epilepsy; Epileptogenic zone; Focal cortical dysplasia; Magnetic resonance imaging; Magnetoencephalography.

MeSH terms

  • Electroencephalography
  • Epilepsies, Partial*
  • Humans
  • Magnetic Resonance Imaging
  • Magnetoencephalography
  • Malformations of Cortical Development*