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Epilepsy Res. 2012 Nov;102(1-2):71-7. doi: 10.1016/j.eplepsyres.2012.05.003. Epub 2012 May 31.

Magnetoencephalography in fronto-parietal opercular epilepsy.

Author information

1
Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA. kakisuke@mui.biglobe.ne.jp

Abstract

OBJECTIVE:

To clarify the clinical and neurophysiological profiles of fronto-parietal opercular epilepsy in which epileptic spikes are detected with magnetoencephalography (MEG) but not with scalp electroencephalography (EEG).

METHODS:

Four patients presented with epileptic spikes localized to the fronto-parietal opercular cortex, which were only appreciated following MEG recordings.

RESULTS:

In all cases, seizure semiology suggested early activation of the operculum and lower peri-rolandic cortex consistent with the somatotopic organization of this region, i.e. tingling sensation involving the throat and hemi-face or contralateral upper limb, and spasms of the neck and throat. MEG spikes were localized in the fronto-parietal operculum. Three of the four patients underwent invasive electrocorticography and/or stereo-EEG recordings, and spikes were confirmed to arise from the estimated area of MEG dipole localization. Two patients remained seizure-free for over 1 year after resection of the epileptogenic region; the other patient declined resective surgery due to proximity to the language cortex.

CONCLUSION:

This study demonstrates the usefulness of MEG in localizing spikes arising from within the fronto-parietal opercular regions, and implies that MEG may provide localizing information in patients with symptoms suggestive of opercular epilepsy, even if scalp EEG recordings fail to disclose any epileptogenic activities.

PMID:
22658720
PMCID:
PMC3645283
DOI:
10.1016/j.eplepsyres.2012.05.003
[Indexed for MEDLINE]
Free PMC Article

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