Abstract
Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG.
Highlights
Epilepsy surgery continues to be a necessity, but the most effective option for many patients with drug resistant epilepsy (DRE) [1]
In a study of focal cortical dysplasia with 1.5T MRI that used a correlation coefficient of greater than 98% and a CV limit of 5 cm3 as an acceptance parameter, more than half of the dipole clusters were larger than the lesion (n = 11/21); 33% were similar to the lesion (n = 7/21); and 14% were smaller than the lesion (n = 3/21) [41]
Classification of temporal dipoles into those of anterior and posterior regions have been suggested [77]. These can be further subclassified into three groups: anterior temporal horizontal (ATH), anterior temporal vertical (ATV), and posterior temporal vertical (PTV), that correlate with temporal tip, anterior superior, and posterior superior temporal planes sources, respectively [77]
Summary
Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG
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