Localization of slow wave activity in patients with tumor-associated epilepsy

Objective: Brain tumors are frequently accompanied by abnormal low frequency magnetic activity (ALFMA). The prevalence and clinical meaning of ALFMA are not well known, although a relation with epileptic brain tissue has been suggested. We studied the prevalence, characteristics and clinical correlates of ALFMA in 20 patients with brain tumors. Methods: In 20 patients with clinical seizures due to a supratentorial tumor, MEG was performed, followed by MR imaging. MEG signals were band pass-filtered (1-4 Hz); the sources of this activity were localized and projected onto the MRI of the patient. Results: Peritumoral ALFMA could be detected in 13 of 20 patients. A pattern of ALFMA distribution around the tumor could be recognized. In eight cases ALFMA also appeared to be localized within the tumor. In three cases ALFMA was also detected in peritumoral white matter. Conclusions: Automatic detection of abnormal delta-activity in patients with a brain tumor and seizures can be performed in a clinical setting. When detected, ALFMA is mostly present in circumscribed regions around the tumor. Presence of ALFMA within the tumor might be an important warning signal for the neurosurgeon that the tumor area comprises functional brain tissue.