Source reconstruction based on subdural EEG recordings adds to the presurgical evaluation in refractory frontal lobe epilepsy

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• 作者：Georgia Ramantani^a ; ^{georgia.ramantani@uniklinik-freiburg.de} ; Delphine Cosandier-Rim&#233 ; l&#233 ; ^b ; Andreas Schulze-Bonhage^a ; ^b ; Louis Maillard^c ; ^d ; Josef Zentner^e ; Matthias Dü ; mpelmann^a
• 关键词：Epilepsy surgery ; Source localization ; Intracranial ; FCD ; Subdural
• 刊名：Clinical Neurophysiology
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：124
• 期：3
• 页码：481-491
• 全文大小：1487 K

文摘

Objective

In presurgical investigations of refractory frontal lobe epilepsy, subdural EEG recordings offer extensive cortical coverage, but may overlook deep sources. Electrical Source Localization (ESL) from subdural recordings could overcome this sampling limitation. This study aims to assess the clinical relevance of this new method in refractory frontal lobe epilepsy associated with focal cortical dysplasia.

Methods

In 14 consecutive patients, we retrospectively compared: (i) the ESL of interictal spikes to the conventional irritative and seizure onset zones; (ii) the surgical outcome of cases with congruent ESL and resection volume to cases with incongruent ESL and resection volume. Each spike type was averaged to serve as a template for ESL by the MUSIC and sLORETA algorithms. Results were superimposed on the corresponding pre and post-surgical MRI.

Results

Both ESL methods were congruent and consistent with conventional electroclinical analysis in all patients. In 7 cases, ESL identified a common deep source for spikes of different 2D localizations. The inclusion of ESL in the resection volume correlated with seizure freedom.

Conclusions

ESL from subdural recordings provided clinically relevant results in patients with refractory frontal lobe epilepsy.

Significance

ESL complements the conventional analysis of subdural recordings. Its potential in improving tailored resections and surgical outcomes should be prospectively assessed.