Page 191 - MEGIN Book Of Abstracts - 2023

magnetoencephalography normal variants that have MEG, the authors have elected to provide an illustrated
no counterparts in EEG. This article reviews benign epi- guide to 10 everyday situations where MEG can help in
leptiform variants and provides examples in EEG and the evaluation of people with drug-resistant epilepsy.
magnetoencephalography. In addition, the potential of They are as follows: (1) lacking or imprecise hypothesis
oscillatory configurations in different frequency bands regarding a seizure onset; (2) negative MRI with a me-
to appear as epileptic activity is discussed. sial temporal onset suspected; (3) multiple lesions on
MRI; (4) large lesion on MRI; (5) diagnostic or therapeu-
Journal of clinical neurophysiology: official publication tic reoperation; (6) ambiguous EEG findings suggestive
of the American Electroencephalographic Society (2020), of "bilateral" or "generalized" pattern; (7) intrasylvian
Vol. 37, No. 6 (33165225) (2 citations) onset suspected; (8) interhemispheric onset suspected;
(9) insular onset suspected; and (10) negative (i.e.,
spikeless) EEG. Only their practical implementation
The 10 Common Evidence-Supported Indications and furtherance of personal and collective education
for MEG in Epilepsy Surgery: An Illustrated will lead to the potentially impactful synergy of the
Compendium (2020) two-MEG and epilepsy surgery. Thus, while fulfilling our
mission as physicians, we must not forget that ignoring
Bagić, Anto I; Funke, Michael E; Kirsch, Heidi E; Tenney, the wealth of evidence about the vast underutilization
Jeffrey R; Zillgitt, Andrew J; Burgess, Richard C of epilepsy surgery - and about the usefulness and
value of MEG in selecting surgical candidates - is far
University of Pittsburgh Comprehensive Epilepsy Center from benign neglect.
(UPCEC), Department of Neurology, University of Pittsburgh
Medical Center (UPMC), Pittsburgh, Pennsylvania, U.S.A; MEG Journal of clinical neurophysiology: official publication
Center, McGovern Medical School, UT Houston, Houston, Tex- of the American Electroencephalographic Society (2020),
as, U.S.A; UCSF Biomagnetic Imaging Laboratory, UCSF, San Vol. 37, No. 6 (33165222) (7 citations)
Francisco, California, U.S.A; MEG Center, Cincinnati Children's
Hospital Medical Center , Department of Pediatrics, University
of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A; Redefining the role of Magnetoencephalography in
Department of Neurology, Beaumont Health Adult Com- refractory epilepsy (2020)
prehensive Epilepsy Center, Neurosicence Center, Royal Oak,
Michigan, U.S.A.; and; Magnetoencephalography Laboratory, Vivekananda, Umesh
Cleveland Clinic Epilepsy Center, Cleveland, Ohio, U.S.A
Department of Clinical and Experimental Epilepsy, Institute of
ABSTRACT Unfamiliarity with the indications for and Neurology, Queen Square, UCL, WC1N 3BG, United Kingdom.
benefits of magnetoencephalography (MEG) persists, Electronic address: [email protected]
even in the epilepsy community, and hinders its ac-
ceptance to clinical practice, despite the evidence. The ABSTRACT Magnetoencephalography (MEG) possesses
wide treatment gap for patients with drug-resistant a number of features, including excellent spatiotempo-
epilepsy and immense underutilization of epilepsy ral resolution, that lend itself to the functional imaging
surgery had similar effects. Thus, educating referring of epileptic activity. However its current use is restricted
physicians (epileptologists, neurologists, and neuro- to specific scenarios, namely in the diagnosis refractory
surgeons) both about the value of epilepsy surgery focal epilepsies where electroencephalography (EEG)
and about the potential benefits of MEG can achieve has been inconclusive. This review highlights the recent
synergy and greatly improve the process of selecting progress of MEG within epilepsy, including advances in
surgical candidates. As a practical step toward a com- the technique itself such as simultaneous EEG/MEG and
prehensive educational process to benefit potential intracranial EEG/MEG recording and room temperature
MEG users, current MEG referrers, and newcomers to MEG recording using optically pumped magnetom-

 ontents  Index 170
C