Division of Child Neurology, 6619UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
6595University of Pittsburgh Medical Center, Department of Radiology, Nuclear Medicine Division, Pittsburgh, PA, USA.
J Child Neurol. 2021 Jul;36(8):673-679. doi: 10.1177/0883073821996558. Epub 2021 Mar 5.
Surgery holds the best outcomes for drug-resistant epilepsy in children, making localization of a seizure focus essential. However, there is limited research on the contribution of magnetoencephalography and single-photon emission computed tomography (SPECT) to the presurgical evaluation of lesional and nonlesional pediatric patients. This study proposed to evaluate the concordance of SPECT and magnetoencephalography (MEG) to scalp electroencephalography (EEG) to determine their effective contribution to the presurgical evaluation. On review, MEG and SPECT studies for 28 drug-resistant epilepsy cases were completed at Children's Hospital of Pittsburgh from May 2012 to August 2018. Although not reaching statistical significance, MEG had increased lobar concordance with EEG compared with SPECT (68% vs 46%). MEG or SPECT results effectively provided localization data leading to 6 surgical evaluations and 3 resections with outcomes of Engel class I or II at 12 months. This study suggests MEG and SPECT provide valuable localizing information for presurgical epilepsy evaluation of children with drug-resistant epilepsy.
手术是治疗耐药性癫痫的最佳方法，因此定位癫痫灶至关重要。然而，关于磁共振波谱和单光子发射计算机断层扫描（SPECT）在病灶性和非病灶性儿科患者术前评估中的作用的研究有限。本研究旨在评估 SPECT 和磁共振波谱（MEG）与头皮脑电图（EEG）的一致性，以确定它们对术前评估的有效贡献。经回顾性分析，2012 年 5 月至 2018 年 8 月期间，匹兹堡儿童医院完成了 28 例耐药性癫痫病例的 MEG 和 SPECT 研究。虽然没有达到统计学意义，但 MEG 与 SPECT 相比，具有更高的与 EEG 一致的脑叶定位（68%比 46%）。MEG 或 SPECT 结果有效提供了定位数据，指导了 6 例手术评估和 3 例切除，术后 12 个月的 Engel 分级为 I 级或 II 级。本研究表明，MEG 和 SPECT 为耐药性癫痫儿童的术前癫痫评估提供了有价值的定位信息。
