TY - JOUR
T1 - Added diagnostic value of magnetoencephalography (MEG) in patients suspected for epilepsy, where previous, extensive EEG workup was unrevealing
AU - Duez, Lene
AU - Beniczky, Sándor
AU - Tankisi, Hatice
AU - Hansen, Peter Orm
AU - Sidenius, Per Christian
AU - Sabers, Anne
AU - Fuglsang-Frederiksen, Anders
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - Diagnosis
KW - Diagnostic yield
KW - Electroencephalography
KW - Epilepsy
KW - Magnetoencephalography
UR - http://www.scopus.com/inward/record.url?scp=84983491034&partnerID=8YFLogxK
M3 - Journal article
SN - 1388-2457
VL - 127
SP - 3301
EP - 3305
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 10
ER -