Brain Topography

, Volume 12, Issue 4, pp 273–282

Localization of the Epileptic Focus by Low-Resolution Electromagnetic Tomography in Patients with a Lesion Demonstrated by MRI

  • Gregory A. Worrell
  • Terrence D. Lagerlund
  • Frank W. Sharbrough
  • Benjamin H. Brinkmann
  • Neil E. Busacker
  • Kathleen M. Cicora
  • Terence J. O'Brien
Article

DOI: 10.1023/A:1023407521772

Cite this article as:
Worrell, G.A., Lagerlund, T.D., Sharbrough, F.W. et al. Brain Topogr (2000) 12: 273. doi:10.1023/A:1023407521772

Abstract

Patients with medically intractable partial epilepsy and well-defined symptomatic MRI lesions were studied using phase-encoded frequency spectral analysis (PEFSA) combined with low-resolution electromagnetic tomography (LORETA). Ten patients admitted to the epilepsy monitoring unit with MRI-identified lesions and intractable partial epilepsy were studied using 31-electrode scalp EEG. The scalp electrodes were located in three-dimensional space using a magnetic digitizer and coregistered with the patient's MRI. PEFSA was used to obtain a phase-encoded scalp map for the ictal frequencies. The ictal generators were obtained from the scalp map using LORETA. In addition, the generators of interictal epileptogenic spikes were identified using time-domain LORETA. The LORETA generators were rostral to the MRI lesion in 87% (7/8) of patients with temporal lobe lesions, but all were located in the mesial temporal lobe in concordance with the patients' MRI lesions. In patients with frontal lobe epilepsy, the ictal generators at the time that the spectral power was maximal localized to the MRI lesions. Eight of 10 patients had interictal spikes, of which 4 were bilateral independent temporal lobe spikes. Only generators of the interictal spikes that were ipsilateral to seizure onset correlated with the ictal generators. LORETA combined with PEFSA of the ictal discharge can localize ictal EEG discharges accurately and improve correlation with brain anatomy by allowing coregistration of the ictal generator with the MRI. Analysis of interictal spikes was less useful than analysis of the ictal discharge.

Epilepsy Frequency analysis Inverse solutions EEG source reconstruction LORETA 

Copyright information

© Human Sciences Press, Inc. 2000

Authors and Affiliations

  • Gregory A. Worrell
    • 1
  • Terrence D. Lagerlund
    • 1
  • Frank W. Sharbrough
    • 1
  • Benjamin H. Brinkmann
    • 2
  • Neil E. Busacker
    • 2
  • Kathleen M. Cicora
    • 1
  • Terence J. O'Brien
    • 1
  1. 1.Department of NeurologyMayo Clinic and Mayo FoundationRochesterUSA
  2. 2.Section of Information Services, Mayo Clinic and Mayo FoundationRochesterUSA

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