Article
Preoperative magnetic resonance imaging enhances seizure outcome in epilepsy surgery for focal cortical dysplasia
Search Medline for
Authors
Published: | June 18, 2018 |
---|
Outline
Text
Objective: Epilepsy surgery for focal cortical dysplasia type II (FCD II) leads to high percentages of seizure free patients, 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.
Methods: We 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, with a mean follow up time of 38.9 months. 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.
Results: 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).
Conclusion: We argue for a high value of conducting a combined MEG-MRI approach in the presurgical workup and resection strategy in patients with FCD II related epilepsy.