Magnetoencephalography (MEG) is recognized as a valuable noninvasive clinical method for localization of the epileptogenic zone and critical functional areas, as part of a pre-surgical evaluation for patients with pharmaco-resistant epilepsy. MEG is also useful in localizing functional areas as part of pre-surgical planning for tumor resection. MEG is usually performed in an outpatient setting, as one part of an evaluation that can include a variety of other testing modalities including 3-Tesla MRI and inpatient video-electroencephalography monitoring. In some clinical circumstances, however, completion of the MEG as an inpatient can provide crucial ictal or interictal localization data during an ongoing inpatient evaluation, in order to expedite medical or surgical planning. Despite well-established clinical indications for performing MEG in general, there are no current reports that discuss indications or considerations for completion of MEG on an inpatient basis. We conducted a retrospective institutional review of all pediatric MEGs performed between January 2012 and December 2020, and identified 34 cases where MEG was completed as an inpatient. We then reviewed all relevant medical records to determine clinical history, all associated diagnostic procedures, and subsequent treatment plans including epilepsy surgery and post-surgical outcomes. In doing so, we were able to identify five indications for completing the MEG on an inpatient basis: (1) super-refractory status epilepticus (SRSE), (2) intractable epilepsy with frequent electroclinical seizures, and/or frequent or repeated episodes of status epilepticus, (3) intractable epilepsy with infrequent epileptiform discharges on EEG or outpatient MEG, or other special circumstances necessitating inpatient monitoring for successful and safe MEG data acquisition, (4) MEG mapping of eloquent cortex or interictal spike localization in the setting of tumor resection or other urgent neurosurgical intervention, and (5) international or long-distance patients, where outpatient MEG is not practical. MEG contributed to surgical decision-making in the majority of our cases. Our clinical experience suggests that MEG should be considered on an inpatient basis in certain clinical circumstances, where MEG data can provide essential information regarding the localization of epileptogenic activity or eloquent cortex, and be used to develop a treatment plan for surgical management of children with complicated or intractable epilepsy.

中文翻译：

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儿童住院脑磁图的适应症-一家机构的经验

磁脑电图（MEG）被公认为是有价值的无创临床方法，可用于定位癫痫发生区和关键功能区域，作为对药物耐药性癫痫患者进行术前评估的一部分。MEG在定位功能区域方面也很有用，作为肿瘤切除术前手术计划的一部分。MEG通常在门诊环境中进行，作为评估的一部分，可以包括多种其他测试方式，包括3-Tesla MRI和住院视频脑电图监测。但是，在某些临床情况下，作为住院患者完成MEG可以在进行中的住院患者评估期间提供重要的眼部或眼部定位数据，以加快医疗或手术计划。尽管总体上已经建立了进行MEG的明确临床指征，但目前尚无报道在住院基础上讨论完成MEG的指征或考虑因素。我们对2012年1月至2020年12月期间进行的所有儿科MEG进行了回顾性机构审查，确定了34例MEG已作为住院病人完成的病例。然后，我们检查了所有相关的医疗记录，以确定临床病史，所有相关的诊断程序以及后续的治疗计划，包括癫痫手术和术后结果。通过这样做，我们能够在住院的基础上确定完成MEG的五个适应症：（1）难治性癫痫持续状态（SRSE），（2）顽固性癫痫伴频繁的临床发作和/或频繁或反复发作癫痫持续状态 （3）难治性癫痫伴脑电图或门诊MEG癫痫发作少见，或其他特殊情况需要住院监测以成功且安全地获得MEG数据;（4）在肿瘤切除或其他情况下，雄辩性皮层或小孔尖峰定位的MEG映射紧急神经外科手术，以及（5）门诊MEG不可行的国际或长途患者。MEG在大多数病例中为手术决策做出了贡献。我们的临床经验表明，在某些临床情况下应考虑在住院患者中考虑MEG，其中MEG数据可以提供有关癫痫发生活动或雄辩性皮层定位的基本信息，