PMC:7160875 / 238-2686 JSONTXT

{"project":"testtesttest","denotations":[{"id":"T5","span":{"begin":1500,"end":1513},"obj":"Body_part"},{"id":"T6","span":{"begin":1942,"end":1955},"obj":"Body_part"},{"id":"T7","span":{"begin":2000,"end":2013},"obj":"Body_part"},{"id":"T8","span":{"begin":2369,"end":2382},"obj":"Body_part"}],"attributes":[{"id":"A5","pred":"uberon_id","subj":"T5","obj":"http://purl.obolibrary.org/obo/UBERON_0001871"},{"id":"A6","pred":"uberon_id","subj":"T6","obj":"http://purl.obolibrary.org/obo/UBERON_0001871"},{"id":"A7","pred":"uberon_id","subj":"T7","obj":"http://purl.obolibrary.org/obo/UBERON_0001871"},{"id":"A8","pred":"uberon_id","subj":"T8","obj":"http://purl.obolibrary.org/obo/UBERON_0001871"}],"text":"The aim of epilepsy surgery in patients with focal, pharmacoresistant epilepsies is to remove the complete epileptogenic zone to achieve long-term seizure freedom. In addition to a spectrum of diagnostic methods, magnetoencephalography (MEG) focus localization is used for planning of epilepsy surgery. We present results from a retrospective observational cohort study of 1000 patients, evaluated using MEG at the University Hospital Erlangen over the time span of 28 years. One thousand consecutive cases were included in the study, evaluated at the University Hospital Erlangen between 1990 and 2018. All patients underwent MEG as part of clinical workup for epilepsy surgery. Of these, 405 patients underwent epilepsy surgery after MEG, with postsurgical follow-ups of up to 20 years. Sensitivity for interictal epileptic activity was evaluated, in addition to concordance of localization with the consensus of presurgical workup on a lobar level. We evaluate MEG characteristics of patients who underwent epilepsy surgery versus patients who did not proceed to surgery. In operated patients, resection of MEG localizations was related to postsurgical seizure outcomes, including long-term results after several years. In comparison, the association of lesionectomy with seizure outcomes was analyzed. Measures of diagnostic accuracy were calculated for MEG resection and lesionectomy. Sensitivity for interictal epileptic activity was 72% with significant differences between temporal and extra-temporal lobe epilepsy. MEG was concordant with the presurgical consensus in 51% and showed additional or more focal involvement in an additional 32%. Patients who proceeded to surgery showed a significantly higher percentage of monofocal MEG results. Complete MEG resection was associated with significantly higher chances to achieve seizure freedom in the short term and long term. Diagnostic accuracy was significant in temporal and extra-temporal lobe cases but was significantly higher in extra-temporal lobe epilepsy (diagnostic odds ratios of 4.4 and 41.6). Odds ratios were also higher in non-lesional versus lesional cases (42.0 vs 6.2). The results show that MEG provides nonredundant information, which significantly contributes to patient selection, focus localization, and ultimately long-term seizure freedom after epilepsy surgery. Specifically in extra-temporal lobe epilepsy and non-lesional cases, MEG provides excellent accuracy."}