第38回日本小児神経外科学会
The 38th Annual Meeting of the Japanese Society for Pediatric Neurosurgery

前の演題 次の演題

第2日目、6月5日(土)B 会場(2階 203, 204)15:30〜16:20

一般口演 11: 機能・てんかん

座長: 榎本貴夫、森岡隆人

O11-1

Synthetic aperture magnetometry kurtosis to localize epileptic foci for children with intractable neocortical epilepsy
SAM(g2)を用いた小児難治性新皮質てんかんの術前焦点局在化

杉山一郎 (SUGIYAMA Ichiro) 1, 3、宮川 正 1、今井克美 2、秋山倫之 3、越智文子 3、大坪 宏 3

東京都立小児総合医療センター 脳神経外科 1、独立行政法人国立病院機構 静岡てんかん・神経医療センター 小児科 2、トロント小児病院 神経科 3

【Rationale】Synthetic aperture magnetometry (SAM) is an adaptive spatial filtering algorithm for magnetoencephalography (MEG). SAM kurtosis (SAM(g2)) provides source locations of intracranial spikes with excess kurtosis value (Kw). To evaluate SAM(g2) in analyzing epileptic foci, we compare SAM(g2) with equivalent current dipole (ECD) in children with intractable neocortical epilepsy (NE).【Methods】54 patients (mean 10.6 year-old) were analyzed. SAM(g2) calculated Kw at each voxel (5mm distance). We defined epileptic voxel of SAM(g2) (evSAM(g2)) as those with local peak Kw higher than half of the maximum and more than 1.0. Clustering of ECDs and grouping of evSAM(g2) were containing more than 6 ECDs, and 3 evSAM(g2) within 1cm of each other respectively. We compared the grouped evSAM(g2) overlapping with ECD clusters.【Results】Single ECD cluster was found in 31 patients and multiple in 23. 32 patients had lesions on MRI. 44 patients had grouped evSAM(g2). Locations of grouped evSAM(g2) overlapping with clusters rated between 0-100% (mean 71%). The mean overlapping rates were 88% in single cluster cases with lesion, 67% without lesion, 73% in multiple clusters with lesion and 41% without lesion. Resective surgeries were performed in 13 patients, 9 of whom have been seizure-free.【Conclusions】SAM(g2) analysis succeeded in localizing epileptic sources correlating with single and multiple ECD clusters in NE. MEG using SAM(g2) and ECD might identify suitable candidates for resective surgery.

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