Neurology ·
Intracranial EEG pattern may help identify MOGHE in drug-resistant epilepsy
A retrospective multicenter study assessed an intracranial EEG pattern in patients with mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE). The pattern showed high agreement with diagnosis in a small independent validation cohort, but prospective studies are needed to confirm its diagnostic and prognostic value.
- LVFA clusters were seen in 16 of 18 MOGHE cases.
- Validation cohort agreement was 90.9%.
- Pattern territory resection was associated with seizure freedom.
- Prospective validation is needed.
Mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE) can be difficult to identify before surgery because imaging may be negative or resemble other cortical lesions. Researchers retrospectively analyzed long-term stereo-EEG and subdural recordings from a test cohort of 18 patients with MOGHE and 20 with other developmental brain lesions, then assessed the candidate pattern in an independent validation cohort of 11 MOGHE and 11 non-MOGHE cases.
The pattern consisted of clusters of very brief, low-voltage fast activity recurring in episodes lasting several minutes; some episodes had no clear clinical symptoms. It was identified in 16 of 18 MOGHE patients and none of the non-MOGHE patients in the test cohort. In validation, blinded visual assessment correctly classified 10 of 11 patients in each group (overall agreement 90.9%; 95% CI, 72.2%–97.5%). Within the MOGHE group, resection of the territory showing the pattern was associated with postsurgical seizure freedom (p=.0021).
The findings suggest a potentially recognizable iEEG feature that could inform presurgical assessment and surgical planning. However, the cohorts were small and retrospective, and the authors call for prospective validation; the pattern is not yet an established diagnostic or prognostic biomarker.
In practice
For patients with drug-resistant focal epilepsy undergoing intracranial EEG, stereotyped clusters of brief low-voltage fast activity may help identify MOGHE, including when imaging is negative or resembles another lesion. In a small independent validation cohort, visual assessment classified 20 of 22 cases correctly; resection of the pattern’s territory was associated with seizure freedom within the MOGHE group. These retrospective findings do not establish clinical utility or justify changing surgical decisions without prospective validation.
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Epilepsia: Repetitive clustered low‐voltage fast activity on intracranial electroencephalogram in mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy: A candidate electroencephalographic biomarker study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.