Page 188 - MEGIN Book Of Abstracts - 2023

tion between hemispheres and language localization 15 phase 2 studies, 10 direct resections, and 9 indirect
within hemisphere. Understanding cortical language resections; 27% owned MEG. On average, 11.2 MEGs
systems is complicated by two primary challenges: the per year were ordered for epilepsy localization and
extent of the neural tissue involved and the substantial 7.6 for any presurgical mapping modalities. Wada test
variability across individuals, especially in pathologi- aka the intracarotid sodium amobarbital procedure
cal populations. We review the contributions made (ISAP) (43%) and functional MRI (29%) were preferred
through the study of electrophysiological activity to ad- over MEG (4%) for language mapping. The number of
dress these challenges. These contributions are based epileptologists and the number of epilepsy monitoring
on the techniques of magnetoencephalography (MEG), unit beds correlated positively with the most clinical
intracerebral recordings, electrical-cortical stimulation volumes. The centers who own a MEG had surgical
(ECS), and the electrovideo analyses of seizures and volumes significantly higher than those without. The
their semiology. We highlight why no single modality number and complexity of patients as well as the prox-
alone is adequate to identify cortical language systems imity of a MEG were perceived as significant contribu-
and suggest avenues for improving current practice. tors/obstacles to increased MEG use.

Keywords: Aphasia, Electrical–cortical stimulation, Electro- CONCLUSIONS Only the centers with larger surgi-
corticography, Magnetoencephalography, Seizure semiol- cal volumes incorporate MEG regularly in presurgical
ogy, Stereotactic electroencephalography evaluation of patients with drug-resistant epilepsy. A
reversal of the pervasive underutilization of epilepsy
Epilepsy & behavior: E&B (2020), Vol. 112 (33181892) (5 surgery can benefit from MEG, but this requires a sus-
citations) tained concerted promotion by the epilepsy and MEG
communities.

Utilization of MEG Among the US Epilepsy Centers: Journal of clinical neurophysiology: official publication
A Survey-Based Appraisal (2020) of the American Electroencephalographic Society (2020),
Vol. 37, No. 6 (33165233) (18 citations)
Bagić, Anto I; Burgess, Richard C

University of Pittsburgh Comprehensive Epilepsy Center Clinical Magnetoencephalography Practice in the
(UPCEC), Department of Neurology, Pittsburgh, Pennsylvania, United States Ten Years Later: A Survey-Based
U.S.A.; and; Magnetoencephalography Laboratory, Cleveland Reappraisal (2020)
Clinic Epilepsy Center, Cleveland, Ohio, U.S.A
Bagić, Anto I; Burgess, Richard C
PURPOSE The purported underutilization of magneto-
encephalography (MEG) among the USA epilepsy cen- University of Pittsburgh Comprehensive Epilepsy Center
ters has never been studied, and any evidence-based (UPCEC), Department of Neurology, Pittsburgh, Pennsylvania,
understanding of its magnitude is lacking. U.S.A.; and; Magnetoencephalography Laboratory, Cleveland
Clinic Epilepsy Center, Cleveland, Ohio, U.S.A
METHODS Two hundred twenty-five National Associa-
tion of Epilepsy Centers centers (2016) were invited to PURPOSE Broader utilization of magnetoencepha-
participate anonymously in a 13-question web-based lography (MEG) and optimization of clinical practice
survey of clinical practice focused on MEG use. remain strategic goals of the American Clinical Magne-
toencephalography Society. Despite the implementa-
RESULTS On average, centers (N = 70; 61 of which tion of the first MEG Clinical Practice Guidelines, clinical
were level 4) reported <6 epileptologists, >7 dedicated adoption has been less than expected, prompting a
epilepsy monitoring unit beds, 206 phase 1 studies, reassessment.

 ontents  Index 167
C