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EEG/MEG-Quellenrekonstruktion bei nichtläsioneller Epilepsie

EEG/MEG source reconstruction in non-lesional epilepsy

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Clinical Epileptology Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Nichtläsionelle Epilepsien haben derzeit ein schlechteres postoperatives Ergebnis als Epilepsien mit Läsionsnachweis. EEG- und MEG-Quellenrekonstruktion (ESI/MSI) leisten zu der präoperativen Eingrenzung des epileptogenen Fokus einen wichtigen Beitrag.

Ziel der Arbeit

Ziel ist es, einen Überblick über den Status quo zu ESI und MSI bei nichtläsionellen Epilepsien zu geben und die Relevanz dieser Techniken in der präoperativen Diagnostik hervorzuheben.

Material und Methoden

Nichtsystematisches Literaturreview.

Ergebnisse und Schlussfolgerungen

Quellenrekonstruktion bei nichtläsionellen Epilepsien hat einen großen Nutzen bezüglich der Lokalisationspräzision des epileptogenen Fokus, was sich in einer Übereinstimmung der Resektionszone bzw. des intrakraniellen EEGs und der Quellenrekonstruktion bei postoperativ anfallsfreien Patienten*innen zeigt. Weiterhin enthält diese Technik nichtredundante Informationen, indem eine bis dahin unerkannte Läsion im Nachhinein identifiziert wurde. Jedoch wird ESI von nur 9, MSI von nur 7 von 25 europäischen Epilepsiezentren zur prächirurgischen Diagnostik eingesetzt. Semiautomatische Quellenrekonstruktion sowie Eingrenzung der Spike- und Elektrodenanzahl könnten helfen, die Praktikabilität und die Verbreitung dieser wichtigen Methoden in den Epilepsiezentren zu erhöhen.

Abstract

Background

The postsurgical outcome of non-lesional epilepsy is worse compared to that of lesional epilepsy. Electric and magnetic source imaging (ESI/MSI) are very important methods for the presurgical identification of the epileptogenic focus.

Objective

The aim of this article is to provide an overview on the current state of knowledge on ESI and MSI in non-lesional epilepsy.

Material and methods

The article presents a non-systematic literature review.

Results and conclusion

Source imaging has proven its usefulness in the localization of the epileptogenic focus in non-lesional epilepsy patients. The concordance of the resection zone or intracranial EEG and the source imaging in patients with a good surgical outcome was high. It provides non-redundant information in a relevant proportion of patients by identifying unknown lesions; however, only 9 of 25 surveyed European epilepsy centers reported using ESI in their presurgical evaluation. Semi-automated source reconstruction and limitation of the number of spikes and electrodes needed could help to improve its practicability and increase its use in epilepsy centers.

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Author information

Authors and Affiliations

  1. Epilepsiezentrum Göttingen, Klinik für Neurologie, Universitätsmedizin Göttingen, Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    Ev-Christin Heide, Daniel van de Velden & Niels K. Focke

  2. Klinik für Neurochirurgie, Universitätsklinikum Halle (Saale), Halle, Deutschland

    Stefan Rampp

  3. Klinik für Neurochirurgie, Universitätsklinikum Erlangen, Erlangen, Deutschland

    Stefan Rampp

  4. Klinik für Neurologie, Universitätsklinikum Genf, Genf, Schweiz

    Margitta Seeck

Authors
  1. Ev-Christin Heide
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  2. Stefan Rampp
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  3. Daniel van de Velden
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  4. Margitta Seeck
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  5. Niels K. Focke
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Corresponding author

Correspondence to Ev-Christin Heide.

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Interessenkonflikt

M. Seeck hat eine minimale Beteiligung an Epilog©. N.K. Focke hat Honorare von Angelini, Bial, Eisai und Jazz Pharma für Vorträge und Beratertätigkeit erhalten. E.-C. Heide, S. Rampp und D. van de Velden geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Heide, EC., Rampp, S., van de Velden, D. et al. EEG/MEG-Quellenrekonstruktion bei nichtläsioneller Epilepsie. Clin Epileptol 36, 111–116 (2023). https://doi.org/10.1007/s10309-023-00579-z

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  • DOI: https://doi.org/10.1007/s10309-023-00579-z

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