Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Clin Neurophysiol. 2020 Jan;131(1):324-329. doi: 10.1016/j.clinph.2019.07.031. Epub 2019 Aug 16.
To investigate the diagnostic added value of electrical source imaging (ESI) in presurgical evaluation of patients with drug resistant focal epilepsy.
Eighty-two consecutive patients were included. We analyzed both low density (LD) and high density (HD) EEG recordings. LD ESI was done on interictal and ictal signals recorded during long-term video-EEG monitoring (LTM), with standard 25 electrodes and age-matched template head models. HD ESI was done on shorter recordings (90-120 min), with 256 electrodes, using individual head model. The multidisciplinary team made decisions first blinded to ESI (based on all other modalities) and then discussed the results of the ESI. We considered that ESI had diagnostic added value, when it provided non-redundant information that changed the patientś management plan.
ESI had diagnostic added value in 28 patients (34%). In most cases (85.7%), these changes were related to planning of the invasive recordings. In nine out of 13 patients, invasive recordings confirmed the localization. Out of eight patients in whom the ESI source was resected, six became seizure-free.
ESI provides non-redundant information in one third of the patients undergoing presurgical evaluation.
This study provides evidence for the diagnostic added value of ESI in presurgical evaluation.
研究电源成像（ESI）在耐药性局灶性癫痫患者术前评估中的诊断附加价值。
共纳入 82 例连续患者。我们分析了低密度（LD）和高密度（HD）EEG 记录。LD ESI 是在长期视频-EEG 监测（LTM）期间记录的发作间期和发作期的间歇性和发作性信号上进行的，使用标准的 25 个电极和年龄匹配的模板头模型。HD ESI 是在较短的记录（90-120 分钟）上进行的，使用 256 个电极，使用个体头模型。多学科团队首先在不考虑 ESI（基于所有其他模式）的情况下做出决策，然后讨论 ESI 的结果。我们认为，当 ESI 提供非冗余信息从而改变患者的治疗计划时，它具有诊断附加价值。
ESI 在 28 例患者（34%）中具有诊断附加价值。在大多数情况下（85.7%），这些变化与侵入性记录的规划有关。在 13 例患者中有 9 例，侵入性记录证实了定位。在 ESI 源被切除的 8 例患者中，有 6 例成为无癫痫发作。
ESI 在接受术前评估的三分之一患者中提供了非冗余信息。
本研究为 ESI 在术前评估中的诊断附加价值提供了证据。
