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Magnetoencephalography as a Prognostic Tool in Patients With Medically Intractable Temporal Lobe Epilepsy

 Chang Kyu Park  ;  Su Jeong Hwang  ;  Na Young Jung  ;  Won Seok Chang  ;  Hyun Ho Jung  ;  Jin Woo Chang 
 WORLD NEUROSURGERY, Vol.123 : e753-e759, 2019-03 
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Adult ; Aged ; Amygdala / surgery ; Anterior Temporal Lobectomy / methods ; Chronic Disease ; Epilepsy, Temporal Lobe / diagnosis* ; Epilepsy, Temporal Lobe / surgery ; Female ; Hippocampus / surgery ; Humans ; Magnetoencephalography* ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Recurrence ; Temporal Lobe / surgery ; Treatment Outcome ; Young Adult
Anterior temporal lobectomy ; Magnetoencephalography ; Prognosis ; Temporal lobe epilepsy
Background: Most surgical treatments for medically intractable temporal lobe epilepsy are helpful. When a patient has persistent symptoms after surgery, there are no tests that accurately predict whether a patient will have remnant epileptic foci. The aim of this study was to evaluate the usefulness of magnetoencephalography (MEG) as a prognostic tool in patients with temporal lobe epilepsy. Methods: From July 2012 to July 2016, 21 patients underwent preoperative and postoperative MEG at our center. Postoperative MEG was performed within 2 weeks after surgery. We analyzed MEG by estimating the time-frequency component of the signal to define gamma oscillations (GOs), which are an indicator of epileptogenic foci. We analyzed the relationship between GOs on MEG and surgical outcomes. Results: Mean follow-up period was 28.3 months (range, 13-44 months). At the last follow-up visit, patients were divided into 2 groups according to surgical outcome. All patients showed spike waves and GOs on preoperative electroencephalography and MEG. In the seizure control group (16 patients), spike waves (2 patients) and GOs (2 patients) were seen postoperatively despite absence of symptoms. In the recurrent seizure group (5 patients), whereas 3 patients showed spike waves, all 5 patients showed GOs on MEG postoperatively. There was a significant association between presence of GOs on postoperative MEG and surgical outcome (P = 0.01). Conclusions: MEG can provide valuable postsurgical information on epileptic foci in patients with recurrent symptoms; GOs on postoperative MEG were especially correlated with epileptic recurrence. Our data show that GOs on postoperative MEG may have prognostic value.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Na Young(정나영)
Jung, Hyun Ho(정현호)
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