Could it be possible to replace an intracranial EEG recording by a MEG in a presurgical evaluation of patients with refractory epilepsy?

Wagner Maya, 2023
Epilepsy is one of the most common neurological disorders, with one in three epilepsy patients being diagnosed with refractory epilepsy. A diagnosis of refractory epilepsy is made when two or more types of anti-seizure medication (ASM) have been tried and have failed to control the seizures. In such cases, the only curative option is often epilepsy surgery. These patients undergo a presurgical evaluation to identify the zone responsible for the seizure, the so-called epileptogenic zone (EZ). This is performed using different invasive and non-invasive techniques. The gold standard for localizing the EZ is the intracranial electroencephalography (iEEG), which is an invasive technique. Nevertheless, this technique is also associated with several disadvantages, including the invasiveness for the patients, which results in a significant risk of complications, and the limited accessibility. This creates the need to evaluate the accuracy of a non-invasive technique, MEG or magnetoencephalography, that may reduce or eliminate the need for iEEG monitoring. MEG, or magnetoencephalography, is a non-invasive technique used in the presurgical evaluation that measures the magnetic signals of the brain. The findings of this study indicate that MEG is not a suitable replacement for iEEG. Rather, it plays a guiding role in the iEEG electrode placement. These results confirm previous literature and demonstrate that the iEEG electrode coverage can be minimized by following the MEG guidelines. Consequently, this approach can be used to minimize the complications and invasiveness of the iEEG.

Promotor Evelien Carrette
Opleiding Biomedische Wetenschappen
Domein Neurosciences
Kernwoorden intracranial EEG, MEG, refractory epilepsy, presurgical evaluation