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The magnetic field of epileptic spikes agrees with intracranial localizations in complex partial epilepsy

From the Department of Neurology (Drs. Sutherling, Crandall, and Barth), Division of Neurosurgery (Drs. Crandall and Cahan), UCLA School of Medicine, and the Department of Psychology (Dr. Barth), University of California, Los Angeles, CA.

The magnetoencephalogram (MEG) and electroencephalogram (EEG) were measured during interictal epileptic spikes in nine patients with complex partial seizures. The MEG localization estimates were compared with localizations by intraoperative cortical electrodes, subdural electrodes, stereotaxic depth electrodes, anatomic imaging, postoperative pathologic analysis, and postoperative follow-up. In all patients, MEG localization estimates were in the same lobe as the epileptic focus determined by invasive methods and EEG. In two patients, it was possible to quantify precisely the accuracy of MEG localization by mapping a spike focus that was visually indistinguishable on MEG and cortical recordings. In both patients, MEG localization was approximately 12 mm from the center of the cortical spike focus on intracranial recordings. In eight patients, MEG showed tangential dipolar field patterns on the spontaneous record, but EEG did not. In one patient, a cortical epileptic discharge was detected only on MEG for some discharges and only on EEG for other discharges. The MEG did not detect deep spikes with present levels of environmental noise.

Address correspondence and reprint requests to Dr. Sutherling, Department of Neurology, UCLA School of Medicine, Reed Neurological Research Center, 710 Westwood Plaza, Los Angeles, CA 90024–1769.

Supported by the National Institute of Neurological and Communicative Disorders and Stroke, Epilepsy Branch, research grant NS20806 and grants from the Research Society for Parkinson's Disease and Movement Disorders and from the Reed Neurological Research Center. Dr. Sutherling is a recipient of a Teacher Investigator Development Award (NS00678) from the National Institute of Neurological and Communicative Disorders and Stroke and of a Merritt-Putnam Fellowship from the Epilepsy Foundation of America.

Received June 16, 1987. Accepted for publication in final form September 3, 1987.