Tuberous Sclerosis Complex (TSC): Identification of the Primary Epileptogenic Tuber
Abstract number :
3.174
Submission category :
Year :
2001
Submission ID :
2806
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
F.E. Jansen, MD, Child Neurology, University Medical Center, Utrecht, Netherlands; G.J. Huiskamp, PhD, Clinical Neurophysiology, University Medical Center, Utrecht, Netherlands; K.A.C. van Huffelen, MD, PhD, Clinical Neurophysiology, University Medical Ce
RATIONALE: Although it is generally assumed that epilepsy in TSC originates from tubers, little is known about their epileptogenicity and the possible correlation between epileptogenicity and the localisation of the tubers. With standard electroencephalography (EEG) it is impossible to identify the exact localisation of the epileptogenic zone and its possible relation to the tuber(s). In this study we propose to analyse the surplus value of simultaneous high resolution (HR) EEG and HR magnetoencephalography (MEG) recordings in combination with advanced magnetic resonance imaging (MRI) in order to detect the epileptogenic zone.
METHODS: Neurophysiological examination:
85 channel EEG recording
151 channel MEG with simultaneous 64 channel EEG recording
Neuroradiological examination:
T1 weighted 3D MRI with marker points, according to CURRY protocol; FLAIR images.
Source- and volume conductor modelling was performed using CURRYV3.0 software.
RESULTS: At this moment, in 12 patients simultaneous EEG and MEG recordings are obtained. Of these patients, unifocal epileptiform activity was recorded in 6. The unifocal epileptiform activity was related to one tuber in 5 patients. The unifocal epileptiform activity was related to the hippocampus in 1 patient. Multifocal epileptiform activity was present in 3 patients. The other 3 patients showed no or only sporadic interictal epileptiform activity.
CONCLUSIONS: Preliminary results of our study have confirmed our hypothesis that it is possible to identify a unifocal epileptogenic source in close relation to a single tuber- at least interictally- in patients with TSC. Clear delineation of the epileptogenic zone may offer opportunities for epilepsy surgery in patients with TSC who were previously considered intractable.