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Published Online First: 20 December 2007. doi:10.1136/jnnp.2007.125401
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:594-597
Copyright © 2008 by the BMJ Publishing Group Ltd.
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SHORT REPORTS

Combined EEG-fMRI and tractography to visualise propagation of epileptic activity

K Hamandi1, H W R Powell1, H Laufs1, M R Symms1, G J Barker2, G J M Parker3, L Lemieux1, J S Duncan1

1 Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
2 Institute of Psychiatry, Kings College London, London, UK
3 Imaging Science & Biomedical Engineering, The University of Manchester, Manchester, UK

Correspondence to:
Dr K Hamandi, The Epilepsy Unit, University Hospital of Wales, Cardiff CF14 4XW, UK; hamandik{at}cardiff.ac.uk

In a patient with refractory temporal lobe epilepsy, EEG-fMRI showed activation in association with left anterior temporal interictal discharges, in the left temporal, parietal and occipital lobes. Dynamic causal modelling suggested propagation of neural activity from the temporal focus to the area of occipital activation. Tractography showed connections from the site of temporal lobe activation to the site of occipital activation. This demonstrates the principle of combining EEG-fMRI and tractography to delineate the pathways of propagation of epileptic activity.






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