Abstracts

As described in current literature, lesional epilepsy is primarily a pediatric disorder. It is often amenable to surgical interventions, particularly when candidates are carefully chosen based on concordant localization studies. New technology is allowing more precise identification of even discrete seizure foci, enabling clinicians to offer surgical options more often for the treatment of seizures. Magnetoencephalography (MEG) is a noninvasive method of identifying epileptogenic zones based on detection of magnetic fields from the electrical activity within cortical neurons. Magnetic Source Imaging (MSI) superimposes MEG data with traditional MRI to provide visual representation of an epileptogenic region within the appropriate anatomical context. Neuroscience nurses who work with epilepsy patients should be familiar with this diagnostic modality in order to effectively communicate with patients and families who are considering surgical intervention for seizure control.
A review of medical and nursing literature was done to summarize the clinical utility and application of MEG and MSI in pediatric epilepsy.
Nursing literature is void of data regarding the use of MEG and MSI. Medical literature reinforces the safety of MEG in children as well as its utility in identification of discrete lesions which may be overlooked in traditional MRI alone. MEG is not distorted by layers of scalp, bone and CSF as is conventional EEG. It accurately detects electrical currents of a seizure focus to within a few millimeters.
Concordant data from all localization studies increase the likelihood that a patient will obtain seizure freedom following epilepsy surgery. As such, MEG may identify patients who are not likely to benefit from surgical interventions thereby eliminating the need for them to endure more invasive intracranial localization techniques. MEG has the potential to routinely contribute to earlier identification of children for whom seizure surgery may provide seizure freedom and result in a life without the morbidity and stigma of epilepsy. Magnetic Source Imaging provides visualization of a seizure focus in the context of anatomical landmarks, and in the future it may replace invasive electrocorticography for localization and somatosensory mapping of eloquent cortex. Nurses are advocates to the patients they serve. As such, they should be equipped to provide patients and families with current, relevant data that contributes to knowledge, understanding and ability to make informed decisions.