EEG Source Imaging (ESI) utility in clinical practice

Document Type

Article

Publication Date

12-1-2020

Abstract

Epilepsy surgery is an important treatment modality for medically refractory focal epilepsy. The outcome of surgery usually depends on the localization accuracy of the epileptogenic zone (EZ) during pre-surgical evaluation. Good localization can be achieved with various electrophysiological and neuroimaging approaches. However, each approach has its own merits and limitations. Electroencephalography (EEG) Source Imaging (ESI) is an emergingmodel-based computational technique to localize cortical sources of electrical activity within the brain volume, three-dimensionally. ESI based pre-surgical evaluation gives an overall clinical yield of 73-91%, depending on choice of head model, inverse solution and EEG electrode density. It is a cost effective, non-invasive method which provides valuable additional information in presurgical evaluation due to its high localizing value specifically inMRI-negative cases, extra or basal temporal lobe epilepsy, multifocal lesions such as tuberous sclerosis or cases with multiple hypotheses. Unfortunately, less than 1% of surgical centers in developing countries use this method as a part of pre-surgical evaluation. This review promotes ESI as a useful clinical tool especially for patients with lesion-negative MRI to determine EZ cost-effectively with high accuracy under the optimized conditions.

Keywords

EEG source imaging, Epilepsy, Epilepsy surgery, Epileptogenic zone

Divisions

fac_med,medicinedept

Funders

Universiti Malaya [Grant No: RP052C-17HTM]

Publication Title

Biomedical Engineering / Biomedizinische Technik

Volume

65

Issue

6

Publisher

De Gruyter

Publisher Location

GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY

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