Canuet Leonides, Ishii Ryouhei, Iwase Masao, Kurimoto Ryu, Ikezawa Koji, Azechi Michiyo, Wataya-Kaneda Mari, Takeda Masatoshi
Departments of Clinical Neuroscience and Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.
J Clin Neurosci. 2008 Nov;15(11):1296-8. doi: 10.1016/j.jocn.2007.03.030. Epub 2008 Sep 7.
The hallmark of tuberous sclerosis is the presence of multiple cortical tubers. Identifying the epileptogenic tubers is difficult and often requires invasive intracranial electroencephalograph (EEG) monitoring. We report on a patient with tuberous sclerosis upon whom the novel magnetoencephalography (MEG) technique of synthetic aperture magnetometry (SAM) with excess kurtosis (g2) analysis was performed for localization of the epileptogenic tuber. Simultaneous electroencephalography (EEG) was also performed. MEG data, as analyzed by SAM(g2), were superimposed on the patient's MRIs. In the fluid attenuated inversion recovery MRIs, several tubers and subependymal nodules could be identified, with the largest tubers being located in the right frontal and left anteriotemporal regions. Despite multiple cortical lesions existing, the SAM(g2) images showed a single large tuber and surrounding epileptogenic tissue in the left temporal cortex. We suggest that MEG with SAM(g2) analysis may be clinically useful for the accurate identification of epileptogenic tubers in patients with tuberous sclerosis.
结节性硬化症的标志是存在多个皮质结节。识别致痫结节很困难，通常需要进行有创性颅内脑电图（EEG）监测。我们报告了一名结节性硬化症患者，对其采用了具有峰度（g2）分析的合成孔径磁力测定法（SAM）这种新型脑磁图（MEG）技术来定位致痫结节。同时也进行了同步脑电图（EEG）检查。通过SAM（g2）分析的MEG数据被叠加到患者的磁共振成像（MRI）上。在液体衰减反转恢复序列MRI中，可以识别出几个结节和室管膜下结节，最大的结节位于右侧额叶和左侧前颞叶区域。尽管存在多个皮质病变，但SAM（g2）图像显示在左侧颞叶皮质有一个大的结节及周围的致痫组织。我们认为，采用SAM（g2）分析的MEG可能在临床上有助于准确识别结节性硬化症患者的致痫结节。
