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Added diagnostic value of magnetoencephalography (MEG) in patients suspected for epilepsy, where previous, extensive EEG workup was unrevealing

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  • Lene Duez
  • Sándor Beniczky
  • Hatice Tankisi
  • Peter Orm Hansen
  • Per Sidenius
  • Anne Sabers
  • Anders Fuglsang-Frederiksen
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OBJECTIVE: To elucidate the possible additional diagnostic yield of MEG in the workup of patients with suspected epilepsy, where repeated EEGs, including sleep-recordings failed to identify abnormalities.

METHODS: Fifty-two consecutive patients with clinical suspicion of epilepsy and at least three normal EEGs, including sleep-EEG, were prospectively analyzed. The reference standard was inferred from the diagnosis obtained from the medical charts, after at least one-year follow-up. MEG (306-channel, whole-head) and simultaneous EEG (MEG-EEG) was recorded for one hour. The added sensitivity of MEG was calculated from the cases where abnormalities were seen in MEG but not EEG.

RESULTS: Twenty-two patients had the diagnosis epilepsy according to the reference standard. MEG-EEG detected abnormalities, and supported the diagnosis in nine of the 22 patients with the diagnosis epilepsy at one-year follow-up. Sensitivity of MEG-EEG was 41%. The added sensitivity of MEG was 18%. MEG-EEG was normal in 28 of the 30 patients categorized as 'not epilepsy' at one year follow-up, yielding a specificity of 93%.

CONCLUSIONS: MEG provides additional diagnostic information in patients suspected for epilepsy, where repeated EEG recordings fail to demonstrate abnormality.

SIGNIFICANCE: MEG should be included in the diagnostic workup of patients where the conventional, widely available methods are unrevealing.

OriginalsprogEngelsk
TidsskriftClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Vol/bind127
Udgave nummer10
Sider (fra-til)3301-5
Antal sider5
ISSN1388-2457
DOI
StatusUdgivet - okt. 2016

ID: 49873816