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Abstract Details

EEG Source Imaging from Standard Long-term Video EEG Recording in Patients with Medically-refractory Focal Epilepsy
Epilepsy/Clinical Neurophysiology (EEG)
P6 - Poster Session 6 (11:30 AM-1:00 PM)
15-004

 Noninvasive localization plays an important role in accurate seizure localization for patients with medically refractory focal epilepsy.  ESI and has been shown to correlate well with surgical area of resection. We report the concordance between ESI and intracranial EEG in a cohort of 20 patients.

 To evaluate EEG source imaging (ESI) from standard long-term video-EEG recording in patients who underwent intracranial monitoring.

 Patients were selected who had ESI performed and  subsequent intracranial monitoring (ICM).  ESI and intracranial seizure onset zone (SOZ) were localized to sublobar regions, and concordance was determined for each ESI analysis.  Minimum (at least one ESI concordant) and complete (all ESI concordant) concordance was determined for each patient. Agreement between ESI and ICM in identifying multifocal SOZ was analyzed.

Twenty patients had a total of 56 ESI analyses, 32 ictal and 24 interictal. There was no significant difference in concordance between ictal (78%) and interictal (58%) analyses. However, when patients with multifocal SOZ were excluded, ictal analyses were significantly more concordant (83% vs 50%, p<0.05). Concordance was not significantly different between temporal (73%) and extratemporal SOZ (63%). Minimal concordance was seen in 95% of patients and complete concordance in 55%. There was no significant difference in minimal or complete concordance between patients with ictal and interictal discharges or patients with temporal and extratemporal SOZ.  

  EEG source imaging from prolonged EEG monitoring shows favorable concordance with SOZ identified by intracranial EEG. Ictal analyses were more likely than interictal to be concordant with ICM.  The majority of patients had all ictal analyses concordant with ICM, with a trend towards lower concordance for interictal analyses. 

Authors/Disclosures
Benjamin C. Cox, MD (University of Alabama at Birmingham)
PRESENTER
Dr. Cox has nothing to disclose.
Omar A. Danoun, MD (Henry Ford Hospital) Dr. Danoun has nothing to disclose.
Lily Wong-Kisiel, MD, FAAN (Mayo Clinic) Dr. Wong-Kisiel has nothing to disclose.
Benjamin H. Brinkmann, PhD (Mayo Clinic) Dr. Brinkmann has received personal compensation in the range of $0-$499 for serving as a Consultant for Otsuka Pharmaceuticals. Dr. Brinkmann has stock in Cadence Neuroscience. The institution of Dr. Brinkmann has received research support from Epilepsy Foundation of America. The institution of Dr. Brinkmann has received research support from National Institutes of Health. The institution of Dr. Brinkmann has received research support from National Institutes of Health. The institution of Dr. Brinkmann has received research support from UNEEG A/S. The institution of Dr. Brinkmann has received research support from Seer Medical Pty. The institution of Dr. Brinkmann has received research support from Neurelis Inc. Dr. Brinkmann has received intellectual property interests from a discovery or technology relating to health care. Dr. Brinkmann has a non-compensated relationship as a Co-Investigator with Medtronic Inc. that is relevant to AAN interests or activities.