October 30, 2019
The latest implementation of advanced technology at Arkansas Children's is the use of magnetoencephalography, or MEG, which is a non-invasive procedure to study human brain activity. It enables doctors to investigate ongoing brain activity on a millisecond-by-millisecond basis, while also showing where in the brain activity is produced. Now, the pediatric neurologists at Arkansas Children's can get the most accurate reading of brain activity in a painless, efficient way.
We turned to Arkansas Children’s Neurologist Dr. Debopam Samanta to gain a better understanding of MEG and its importance in diagnosing and treating epilepsy and other neurological disorders.
Physicians have used electroencephalogram (EEG) technology to detect brain activity for almost a century. However, the study of magnetic activity in the brain has only been available for the last 50 years. This more specialized method of studying the brain is used to gain a better and more in-depth understanding of many different neurological disorders.
"MEG technology helps us learn about normal brain activity as well as abnormal brain activity," Samanta said. "MEG can non-invasively detect abnormal brain activity for patients with epilepsy, different neurodegenerative disorders like Alzheimer's or Parkinson's, or in patients with a brain tumor."
The primary clinical use for MEG technology is in patients with epilepsy, Samanta said. The electrical storm that takes place in the brain of someone with epilepsy moves so quickly it cannot be detected with an EEG scan. With MEG technology, doctors can precisely identify where the seizure is coming from without invasive surgery. This is especially beneficial for patients who don't respond to seizure medication. In these cases, surgery to remove the part of the brain where seizures are coming from is typically the next step.
"In Arkansas, we have approximately 7,000 kids with pediatric epilepsy," Samanta said. "Around 2,000 of these children are unresponsive to seizure medicine, but on average, we only do around ten epilepsy surgeries a year. Granted, not everyone will be a candidate, but having MEG technology allows us to identify more appropriate treatment options and provide epilepsy surgery when needed."
A MEG scan is a painless study that involves no radiation or injections. Similar to the EEG process, many patients sleep during the first half of the procedure, which lasts approximately one hour. The first part of the study detects abnormal magnetic activity within the brain. The next step is to identify the part of the brain generating normal magnetic activity using a small signal, or stimulus, over the nerve. The patient is awake during this step of the procedure.
"When a surgeon prepares for surgery, they need to know where the normal areas of the brain are and what the relation is to the abnormal area where the seizure is originating," Samanta said. "The goal is to make sure surgeons don't get too close to the normal areas during surgery. This is also true for brain tumor patients who undergo a MEG scan."
Samanta estimates that out of every 100 patients with epilepsy, approximately 20-30 could be candidates for MEG technology. Many patients with brain tumors could also be candidates, as these are the two main approved clinical uses.
As technology and research advance, MEG scans could soon be used to diagnose and determine treatment for a variety of patients, including:
"We are finding out that MEG is much more sensitive than even a CT scan or MRI to detect abnormal brain activity after a head injury," Samanta said.
The nationally recognized Neurology & Neurosurgery Departments at Arkansas Children's provides expert epilepsy care as well as comprehensive care for a full range of neurological conditions and diseases. The clinic offers the diagnosis and treatment of disorders of the peripheral and central nervous system, including nerves, blood vessels and muscles. Pediatric neurologists at Arkansas Children's offer the most advanced research and the latest techniques and approaches to disease management for improved outcomes.
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