Purpose. To evaluate the congruence or discrepancy of the localization of magnetic resonance imaging (MRI) lesions with interictal epileptiform discharges (IEDs) or epileptic seizure patterns (ESPs) in surface EEG in lesional pediatric epilepsy patients. Methods. We retrospectively analyzed presurgical MRI and video-EEG monitoring findings of patients up to age 18 years. Localization of MRI lesions were compared with ictal and interictal noninvasive EEG findings of patients with frontal, temporal, parietal, or occipital lesions. Results. A total of 71 patients were included. Localization of ESPs showed better congruence with MRI in patients with frontal lesions (n = 21, 77.5%) than in patients with temporal lesions (n = 24; 40.7%) (P = .009). No significant IED distribution differences between MRI localizations could be found. Conclusions. MRI lesions and EEG findings are rarely fully congruent. Congruence of MRI lesions and ESPs was highest in children with frontal lesions. This is in contrast to adults, in whom temporal lesions showed the highest congruency with the EEG localization of ESP. Lesional pediatric patients should be acknowledged as surgical candidates despite incongruent findings of interictal and ictal surface EEG.

中文翻译：

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小儿癫痫发作间期和发作期脑电图与 MRI 病变的一致性和差异

目的。评估磁共振成像 (MRI) 病变与发作间期癫痫样放电 (IED) 或癫痫发作模式 (ESP) 在病变儿科癫痫患者的表面 EEG 中定位的一致性或差异。方法。我们回顾性分析了 18 岁以下患者的术前 MRI 和视频脑电图监测结果。MRI 病变的定位与额叶、颞叶、顶叶或枕叶病变患者的发作期和发作间期无创脑电图结果进行比较。结果。共纳入 71 名患者。与颞部病变患者 (n = 24; 40.7%) 相比，ESP 定位在额叶病变患者 (n = 21, 77.5%) 中与 MRI 的一致性更好 (P = .009)。未发现 MRI 定位之间的显着 IED 分布差异。结论。MRI 病变和 EEG 结果很少完全一致。MRI 病变和 ESP 的一致性在有额叶病变的儿童中最高。这与成人形成对比，成人的颞部病变与 ESP 的 EEG 定位显示出最高的一致性。尽管发作间期和发作期表面脑电图的结果不一致，但应承认病变儿科患者是手术候选者。