OBJECT: The authors sought to validate magnetoencephalography spike sources (MEGSSs) in neuronavigation during epilepsy surgery in pediatric patients. METHODS: The distributions of MEGSSs in 16 children were defined and classified as clusters (Class I), greater than or equal to 20 MEGSSs with 1 cm or less between MEGSSs; small clusters (Class II), 6 to 19 with 1 cm or less between; and scatters (Class III), less than 6 or greater than 1 cm between spike sources. Using neuronavigation, the MEGSSs were correlated to epileptic zones from intra- and extraoperative electrocorticography (ECoG), surgical procedures, disease entities, and seizure outcomes. Thirteen patients underwent MEGSSs: nine had clusters; two had small clusters, one with and one without clusters; and three had scatters alone. All 13 had scatters. Clusters localized within and extended from areas of cortical dysplasia and at margins of tumors or cystic lesions. All clusters were colocalized to ECoG-defined epileptic zones. Four of 10 patients with clusters and/or small clusters underwent complete excisions, and six underwent partial excision with or without multiple subpial transections. In the three patients with scatters alone, ECoG revealed epileptic zones buried within MEGSS areas; these regions of scatters were completely excised and treated with multiple subpial transections. Coexisting scatters were left untreated in nine of 10 patients. Postoperatively, nine of 13 patients were seizure free; the four patients with residual seizures had clusters in unresected eloquent cortex. Three patients in whom no MEGSSs were demonstrated underwent lesionectomies and were seizure free. CONCLUSIONS: Magnetoencephalography spike source clusters indicate an epileptic zone requiring complete excision. Coexisting scatters remote from clusters are nonepileptogenic and do not require excision. Scatters alone, however, should be examined by ECoG; an epileptic zone may exist within these distributions.
OBJECT: The authors sought to validate magnetoencephalography spike sources (MEGSSs) in neuronavigation during epilepsy surgery in pediatric patients. METHODS: The distributions of MEGSSs in 16 children were defined and classified as clusters (Class I), greater than or equal to 20 MEGSSs with 1 cm or less between MEGSSs; small clusters (Class II), 6 to 19 with 1 cm or less between; and scatters (Class III), less than 6 or greater than 1 cm between spike sources. Using neuronavigation, the MEGSSs were correlated to epileptic zones from intra- and extraoperative electrocorticography (ECoG), surgical procedures, disease entities, and seizure outcomes. Thirteen patients underwent MEGSSs: nine had clusters; two had small clusters, one with and one without clusters; and three had scatters alone. All 13 had scatters. Clusters localized within and extended from areas of cortical dysplasia and at margins of tumors or cystic lesions. All clusters were colocalized to ECoG-defined epileptic zones. Four of 10 patients with clusters and/or small clusters underwent complete excisions, and six underwent partial excision with or without multiple subpial transections. In the three patients with scatters alone, ECoG revealed epileptic zones buried within MEGSS areas; these regions of scatters were completely excised and treated with multiple subpial transections. Coexisting scatters were left untreated in nine of 10 patients. Postoperatively, nine of 13 patients were seizure free; the four patients with residual seizures had clusters in unresected eloquent cortex. Three patients in whom no MEGSSs were demonstrated underwent lesionectomies and were seizure free. CONCLUSIONS: Magnetoencephalography spike source clusters indicate an epileptic zone requiring complete excision. Coexisting scatters remote from clusters are nonepileptogenic and do not require excision. Scatters alone, however, should be examined by ECoG; an epileptic zone may exist within these distributions.
Authors: I S Mohamed; H Otsubo; E Pang; S H Chuang; J T Rutka; P Dirks; S K Weiss; O C Snead Journal: J Neurol Neurosurg Psychiatry Date: 2006-08-04 Impact factor: 10.154
Authors: Hiroatsu Murakami; Zhong I Wang; Ahmad Marashly; Balu Krishnan; Richard A Prayson; Yosuke Kakisaka; John C Mosher; Juan Bulacio; Jorge A Gonzalez-Martinez; William E Bingaman; Imad M Najm; Richard C Burgess; Andreas V Alexopoulos Journal: Brain Date: 2016-11-01 Impact factor: 13.501
Authors: Naoaki Tanaka; Christos Papadelis; Eleonora Tamilia; Michel AlHilani; Joseph R Madsen; Phillip L Pearl; Steven M Stufflebeam Journal: Pediatr Neurol Date: 2018-03-15 Impact factor: 3.372
Authors: D Mata-Mbemba; Y Iimura; L-N Hazrati; A Ochi; H Otsubo; O C Snead; J Rutka; E Widjaja Journal: AJNR Am J Neuroradiol Date: 2018-11-15 Impact factor: 3.825
Authors: Edward F Chang; Srikantan S Nagarajan; Mary Mantle; Nicholas M Barbaro; Heidi E Kirsch Journal: J Neurosurg Date: 2009-12 Impact factor: 5.115
Authors: Ron Grondin; Sylvester Chuang; Hiroshi Otsubo; Stephanie Holowka; O Carter Snead; Charles Raybaud; James T Rutka Journal: Childs Nerv Syst Date: 2006-06-28 Impact factor: 1.475