Source:Pediatric Neurology
Author(s): Naoaki Tanaka, Christos Papadelis, Eleonora Tamilia, Michel AlHilani, Joseph R. Madsen, Phillip L. Pearl, Steven M. Stufflebeam
BackgroundThe purpose of this study is to clarify the source distribution patterns of magnetoencephalographic (MEG) spikes correlated with postsurgical seizure-free outcome in pediatric patients with focal cortical dysplasia (FCD).MethodsThirty-two patients with pathologically-confirmed FCD were divided into seizure-free and -persistent groups according to their surgical outcomes based on Engel's classification. In each patient, presurgical MEG was retrospectively reviewed. Dipole sources of MEG spikes were calculated according to a single dipole model. We obtained the following quantitative indices for evaluating dipole distribution: maximum distance over all pairs of dipoles, standard deviation of the distances between each dipole and the mean coordinate of all dipoles, average nearest neighbor distance, the rate of dipoles located within 10 mm, 20 mm, 30 mm from the mean coordinate, and the rate of dipoles included in the resection. These indices were compared between the two patient groups.ResultsAverage nearest neighbor distance was significantly smaller in the seizure-free group compared to the seizure-persistent group (p=0.008). The rate of dipoles located within 10 mm, 20 mm, 30 mm from the mean coordinate were significantly higher in the seizure-free group (p=0.001, 0.001, 0.005, respectively). The maximum distance, standard deviation and the resection rate of dipoles did not show a significant difference between the two groups.ConclusionsA spatially-restricted dipole distribution of MEG spikes is correlated with postsurgical seizure-free outcomes in patients with FCD. The distribution can be assessed by quantitative indices that are clinically useful in the presurgical evaluation of these patients.
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