TY - JOUR

T1 - Diagnostic added value of electrical source imaging in presurgical evaluation of patients with epilepsy

T2 - A prospective study

AU - Foged, Mette Thrane

AU - Martens, Terje

AU - Pinborg, Lars H.

AU - Hamrouni, Nizar

AU - Litman, Minna

AU - Rubboli, Guido

AU - Leffers, Anne-Mette

AU - Ryvlin, Philippe

AU - Jespersen, Bo

AU - Paulson, Olaf B.

AU - Fabricius, Martin

AU - Beniczky, Sándor

PY - 2020

Y1 - 2020

N2 - Objective: To investigate the diagnostic added value of electrical source imaging (ESI) in presurgical evaluation of patients with drug resistant focal epilepsy. Methods: Eighty-two consecutive patients were included. We analyzed both low density (LD) and high density (HD) EEG recordings. LD ESI was done on interictal and ictal signals recorded during long-term video-EEG monitoring (LTM), with standard 25 electrodes and age-matched template head models. HD ESI was done on shorter recordings (90–120 min), with 256 electrodes, using individual head model. The multidisciplinary team made decisions first blinded to ESI (based on all other modalities) and then discussed the results of the ESI. We considered that ESI had diagnostic added value, when it provided non-redundant information that changed the patientś management plan. Results: ESI had diagnostic added value in 28 patients (34%). In most cases (85.7%), these changes were related to planning of the invasive recordings. In nine out of 13 patients, invasive recordings confirmed the localization. Out of eight patients in whom the ESI source was resected, six became seizure-free. Conclusions: ESI provides non-redundant information in one third of the patients undergoing presurgical evaluation. Significance: This study provides evidence for the diagnostic added value of ESI in presurgical evaluation.

AB - Objective: To investigate the diagnostic added value of electrical source imaging (ESI) in presurgical evaluation of patients with drug resistant focal epilepsy. Methods: Eighty-two consecutive patients were included. We analyzed both low density (LD) and high density (HD) EEG recordings. LD ESI was done on interictal and ictal signals recorded during long-term video-EEG monitoring (LTM), with standard 25 electrodes and age-matched template head models. HD ESI was done on shorter recordings (90–120 min), with 256 electrodes, using individual head model. The multidisciplinary team made decisions first blinded to ESI (based on all other modalities) and then discussed the results of the ESI. We considered that ESI had diagnostic added value, when it provided non-redundant information that changed the patientś management plan. Results: ESI had diagnostic added value in 28 patients (34%). In most cases (85.7%), these changes were related to planning of the invasive recordings. In nine out of 13 patients, invasive recordings confirmed the localization. Out of eight patients in whom the ESI source was resected, six became seizure-free. Conclusions: ESI provides non-redundant information in one third of the patients undergoing presurgical evaluation. Significance: This study provides evidence for the diagnostic added value of ESI in presurgical evaluation.

KW - Diagnostic added value

KW - Electrical source imaging

KW - Epilepsy surgery

KW - High density EEG

KW - Long term video EEG monitoring

U2 - 10.1016/j.clinph.2019.07.031

DO - 10.1016/j.clinph.2019.07.031

M3 - Journal article

C2 - 31466846

AN - SCOPUS:85071116921

VL - 131

SP - 324

EP - 329

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

IS - 1

ER -