Magnetoencephalography in epilepsy: tailoring interpretation and making inferences.

Overview

Although the ability of magnetoencephalography (MEG) to detect epileptiform discharges noninvasively has long been known, only recently has it become a common tool in clinical settings. Whether MEG or electroencephalography (EEG) is superior has been controversial; MEG has a theoretic edge over EEG for precise localization, but EEG has many practical advantages. Experience has shown that they often provide different and complementary information. Although the results of careful MEG analysis can be quite precise, MEG interpretation, like that of EEG, is partly subjective and reader dependent. Therefore, the appearance of well-defined foci on MEG should not reflexively be regarded as conclusive, but weighed by judgment, experience, and an understanding of the assumptions and behavior of the localization model. We review selected studies in the past 2 years that are relevant to epilepsy. In particular, studies are described that provide insights into MEG's relation to EEG, its contribution to preoperative decision making, its application to benign Rolandic epilepsy, and analysis of secondary generalization.