Objective: To assess the interictal epileptic discharges (IEDs) detection rate of magnetoencephalography (MEG) recordings performed in a new light-weight magnetic shielding (LMSR) concept in a large group of consecutive patients with presumed mesiotemporal lobe epilepsy (MTLE).
Methods: Thirty-eight patients (23 women; age range: 6-63 years) with presumed MTLE were prospectively studied. MEG investigations were performed with the 306-channel Elekta Neuromag® MEG-system installed in a normal hospital environment into a LMSR (MaxShield, Elekta Oy). Equivalent current dipoles (ECD, g/% > 80%) corresponding to epileptic events were fitted to each patient's spherical head model at IEDs onset and peak and then superimposed on the patient's co-registered MRI.
Results: IEDs were observed in 26 out of 38 patients (68.4%). Temporal ECDs were mesial in 14 patients, anterior in 23 patients and posterior in 8 patients. Interestingly, in 6 patients, ECDs fitted at spike-onset were localized in the hippocampus while at the peak of the spike, they had an anterior temporal location.
Conclusions: MEG using LMSR provides adequate signal to noise ratio (SNR) to allow reliable detection and localization of single epileptic abnormalities on continuous MEG data in 68% of patients with presumed MTLE. Moreover, mesial temporal epileptic sources were detected in 54% of patients with abnormal MEG. The SNR of MEG data acquired using the LMSR is therefore suitable for the non-invasive localization of epileptic foci in patients with MTLE. The use of LMSR, which are cheaper and smaller than conventional MSR, should facilitate the development of MEG in clinical environments.
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