Ishibashi H, Morioka T, Shigeto H, Nishio S, Yamamoto T, Fukui M
Department of Neurosurgery, Neurological Institute, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Neurol. 1998 Aug;50(2):157-63. doi: 10.1016/s0090-3019(97)00411-4.
Although magnetoencephalography (MEG) provides accurate information on the spatial distribution and temporal patterns of the "interictal" epileptic activities, it is interictal in nature and therefore also prone to all the problems associated with interictal data.
We investigated the subclinical "ictal" epileptic activity with a 37-channel, large-array biomagnetometer and mapped the data onto a three-dimensional image in a patient with intractable frontal lobe epilepsy. Dipole source localization was calculated based on magnetic fields for both the interictal and subclinical ictal activities.
The current dipoles of the interictal MEG spikes (MEG irritative zone) were revealed to be scattered in the left anterior frontal lobe, whereas that of the subclinical ictal onset (MEG subclinical ictal onset zone) was surrounded by the interictal dipole cluster. The dipole source localization of the propagating activities was not calculated with a single dipole model. The MEG subclinical ictal onset zone correlated well with the ictal onset zone subsequently recorded by invasive subdural electrophysiological monitoring. After multiple subpial transection of the deduced epileptogenic area, a dramatic reduction of the seizures occurred.
These results illustrate the potential of MEG for localizing the epileptogenic foci with high spatial and temporal resolution.
尽管脑磁图（MEG）能提供关于“发作间期”癫痫活动的空间分布和时间模式的准确信息，但它本质上是发作间期的，因此也容易出现与发作间期数据相关的所有问题。
我们使用一台37通道的大型阵列生物磁强计研究了一名难治性额叶癫痫患者的亚临床“发作期”癫痫活动，并将数据映射到三维图像上。基于磁场计算发作间期和亚临床发作期活动的偶极子源定位。
发作间期MEG棘波（MEG刺激区）的电流偶极子显示散在于左前额叶，而亚临床发作起始（MEG亚临床发作起始区）的电流偶极子被发作间期偶极子簇包围。传播活动的偶极子源定位未用单偶极子模型计算。MEG亚临床发作起始区与随后通过侵入性硬膜下电生理监测记录的发作起始区相关性良好。在对推断的致痫区域进行多次软膜下横切术后，癫痫发作显著减少。
这些结果说明了MEG在以高空间和时间分辨率定位致痫灶方面的潜力。
