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DH got approved for a Magnetoencephalogram (MEG)


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We got awesome news today: DH's neurosurgeon's request for an Magnetoencephalogram was approved by his insurance. Last time, in 2007, when the VEEG imaging wasn't as good, they refused it, saying there wasn't enough of an indication of a particular area to explore. This time, the doctors were really happy during DH's VEEG, they were positive they were going to get the MEG. And they were right.

UCSF called to schedule (that is how we found out), and they were talking late next week, when DH mentioned he had a seizure last night. The person making the appointment asked if he had seizures in clusters, and he said yes, so she put him on Friday. He is supposed to be sleep deprived. At this point, he is having micro-seizures all the time, at least according to his last few EEGs. So there is a very good chance they will get a micro-seizure, and a middling chance they can get a partial, or a partial with generalization.

Now the question is: What are they doing exactly, and what would they be looking for? I looked up the Wikipedia MEG explanation, and it is way too advanced, or complex, or uses vocabulary I don't know, talking about vectors, and angles of magnetism, etc. In other words, physics. Even though I do have that spatial learning issue that means I will never entirely understand physics, I can understand it at an intelligent lay person's level. I read Stephen Hawkings' book, and The First Three Minutes, and one or two others, and can understand it in a general way (One part of Hawkings book flew right over my head, I admit).

I know there are people on here that know physics, and I believe some of them have epilepsy. I would appreciate any explanation. At all. Everyone is very excited about it, and so I am too, but I really don't know what is happening.

Thanks if you can help.

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From Wiki:

The clinical uses of MEG are in detecting and localizing pathological activity in patients with epilepsy, and in localizing eloquent cortex for surgical planning in patients with brain tumors or intractable epilepsy.

MEG detects the location of brain tissue that is causing seizures. MEG can be used to map functions like movement and vision to specific areas of the brain. These areas must be avoided during surgery.

nf

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Hmm. I had never heard the term "eloquent cortex" before. Thanks.

So they are mapping out the untouchable spots, and then will later find out if the focus is in one of those places?

And if he has a seizure, will they be able to find the focus as well, or is that a matter of luck?

They know it is in his occipital lobe (I always get the wrong one, I think it is right). They said they are prepared to do *some* damage to his vision when removing a focus, because a) having eyesight problems in one eye isn't as big of an issue as constantly having seizures, and b) because they think that there is a good chance that the brain will compensate for the "hole" in his vision, and kind of digitally paint it in. I mean, I think they can find the blind spot if they look for it, but it won't be apparent on a day to day basis.

They did say they want to leave eyesight in that eye, so they won't totally remove it. And I am pretty certain this is one of those surgeries for which he has to be awake.

I want to get Aisha Tyler's "Boogedy Boogedy Cheese" t-shirts. "Boogedy Boogedy Cheese" was a phrase she used as an example of something you might say if surgeons hit on a part of brain you might want to hang onto for future use, while deciding what parts to remove.

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A general explanation would be that MEG uses measurements of the brain's magnetic fields to map activity on short timescales (say 10 milliseconds). I could see the advantage of this in finding the epileptic focus.

This imaging technique is in contrast to others that measure activity by electric fields (EEG), blood flow (fMRI), and metabolism (PET) - all of which aren't as fast as MEG and have some other limitations. But I wouldn't be surprised if your DH got some of those too.

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Trying hard to remember talks given on this subject back when I was in grad school for neuroscience (although those talks were mostly about infant language learning, but the technique's the same)...

I think the main thing is that MEG is sort of intermediate between EEG and MRI. MRI is very accurate as far as anatomy is concerned (localizing things like tumors), but it is too slow to pick up on seizures (takes at least a couple of seconds up to several minutes). EEG on the other hand is very fast, so it can pick up on seizures, but it's very hard to localize things precisely from an EEG reading. MEG is sort of in between. It is quite fast (not quite as fast as EEG, I think, but fast enough to pick up on seizures), but it also allows you to pinpoint a seizure's focus far more accurately than can be done from EEG. Since you say your husband's focus is in his occipital lobe, I don't know if they will be looking for "untouchable spots", since the occipital lobe doesn't have anything to do with really important functions like language or movement. They may want to map the higher-order visual areas in the occipital lobe, though, since removing those could cause him to lose his ability to see color or to see (fluid) movement (removal of this area will cause everything to look like it's being illuminated by a strobe light, basically).

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Wow. Gah. He just had a bad seizure and fugue, I have been kind of managing him, and finally got him into bed about 5 minutes ago. He pissed all over our front door, I guess he thought it was the bathroom, because I struggled with him to keep it locked. So augh. I thought I would be asleep by now, but hurray for adrenaline.

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Wow. Gah. He just had a bad seizure and fugue, I have been kind of managing him, and finally got him into bed about 5 minutes ago. He pissed all over our front door, I guess he thought it was the bathroom, because I struggled with him to keep it locked. So augh.

I am happy for you that this most sophisticated diagnostic test has been approved by insurance. That is great. You have been dealing with a difficult situation for a long time. I am hoping this will lead to a more successful treatment for your husband.

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