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PubMed1993

Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group.

OBJECTIVE: The Eastern Cooperative Oncology Group (ECOG) conducted a groupwide survey to determine the amount of knowledge about cancer pain and its treatment among physicians practicing in ECOG-affiliated institutions and to determine the methods of pain control being used by these physicians. DESIGN: Survey. SETTING: A questionnaire was sent to all ECOG physicians with patient care responsibilities (medical oncologists, hematologists, surgeons, and radiation therapists), practicing in university institutions, Community Clinical Oncology Program (CCOP) institutions, and Cooperative Group Outreach Programs (CGOP) institutions. MEASUREMENTS: A physician cancer pain questionnaire developed by the Pain Research Group at the University of Wisconsin was used. The questionnaire was designed to assess physicians' estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of cancer pain management, and their report of how they manage pain in their own practice setting. RESULTS: The study analyzed responses to 897 of 1800 surveys. In regard to the use of analgesics for cancer pain in the United States, 86% felt that the majority of patients with pain were undermedicated. Only 51% believed pain control in their own practice setting was good or very good; 31% would wait until the patient's prognosis was 6 months or less before they would start maximal analgesia. Adjuvants and prophylactic side-effect management should have been used more frequently in the treatment plan. Concerns about side-effect management and tolerance were reported as limiting analgesic prescribing. Poor pain assessment was rated by 76% of physicians as the single most important barrier to adequate pain management. Other barriers included patient reluctance to report pain and patient reluctance to take analgesics (both by 62%) as well as physician reluctance to prescribe opioids (61%). CONCLUSIONS: Professional education needs to focus on the proper assessment of pain, focus on the management of side effects, and focus on the use of adjuvant medications. A better understanding of the pharmacology of opioid analgesics is also needed. Physicians also need to educate patients to report pain and to effectively use the medications that are prescribed for pain management.

Adult↗

PubMed1976

Hippocampal theta activity in the acute pretrigeminal cat.

In five cats with a pretrigeminal brainstem transection ocular behavior and cortical and hippocampal EEG activity were recorded. The ECoG desynchronization was usually accompanied by clear hippocampal theta activity. The episodes of ECoG desynchronization and hippocampal theta activity lasted in some cases for several hours. Visual stimuli evoked two types of hippocampal EEG response: (I) increase of regularity and frequency of theta activity (II) EEG desynchronization. The intensity of these responses was positively correlated with the intensity of ocular and ECoG components of the orienting reflex (the most conspicuous phenomenon being their habituation with stimulus repetition). Electrical stimulation of the midbrain reticular formation evoked theta activity of a frequency proportional to stimulus voltage; for maintaining it constant stimulus strength had to be elevated gradually. Depriving the brain of influences from the lower brainstem does not influence qualitatively the function of reticulo-septo-hippocampal system.

Animals↗

PubMed1998

[The role of the posterior hypothalamus in the regulation of paradoxical sleep].

Posterior hypothalamus was found to take part in the inhibitory control of the paradoxical sleep executive mechanisms responsible for the ECoG desynchronisation and phasic events. Functional activity of the posterior hypothalamus seems to be at its lowest during the paradoxical sleep stage as characterised by phasic events and the ECoG desynchronisation, and increases during the stage with alpha-like activity in the ECoG and absence of phasic events, the latter having, probably, a "sentinel" function.

Animals↗

PubMed1999

Immunotherapy of pulmonary metastatic renal cell carcinoma: success dependant on risk factors?

BACKGROUND/AIMS: Risk factors may influence not only prognosis in metastic renal cell carcinoma but also probability of response to immunotherapy. Response of patients treated with inhalation of interleukin-2 (IL-2), which can be offered to those not suitable for systemic therapy, was compared to risk factors. We report on 116 patients who used inhaled IL-2 and were treated in different protocols with natural, recombinant glycosylated and recombinant non-glycosylated. METHODOLOGY: All protocols had in common a high-dose inhalation of IL-2, either exclusively (11%), with low-dose systemic IL-2 (33%), or with low-dose systemic IL-2 and interferon-alpha (56%). Maximal toxicity per total treatment time (median treatment time: 7.2 months) was mild and there was a low incidence (16%) of WHO grade 3 toxicity. Treatment response was analyzed in a subgroup of patients having at least one given risk factor and treated with recombinant IL-2 (n=86). In all patients having risk factors the following distribution was found: more than 1 metastic location (86%), diagnosis to treatment interval (DTI) <12 months (62%), weight loss prior to therapy (41%), and ECOG performance status > or =2 (13%). In comparison, a group of patients having no risk factors at all was analyzed accordingly. RESULTS: Response to immunotherapy is dependant on risk factors, the most prominent one being the ECOG. Patients with an ECOG > or =2 achieved no overall response compared to patients with no risk factors who responded to immunotherapy (33%). Progressive pulmonary metastases responded in 15% of patients for a median of 15.5 months (range: 4.133) and were stabilized in 55% for a median of 6.6 months (range: 3-51.7). Overall response rate was 16%, 49%, and 35%, respectively. Median overall response duration was 9.6 months. Median achieved survival was 11.8 months (range: 1.7-68.8). CONCLUSIONS: We conclude that risk factors have to be considered in the interpretation of response to immunotherapy. Exclusion of patients because of risk factors alone does not seem to be justified according to our data. Responses, including long-term stabilization, can be achieved in 27-57% of such patients. IL-2 immunotherapy can also be considered as useful antitumor therapy in patients with risk factors, especially if given without major toxicity.

Administration, Inhalation↗

PubMed1999

Electrocochleographic evaluation of hearing loss in acoustic neuromas.

OBJECTIVE: This study aimed to clarify the pathophysiology involved in the cause of hearing impairment due to acoustic neuromas (AN) with electrocochleograph (ECoG). STUDY DESIGN: The study design was a retrospective case study. SETTING: This study was conducted in a tertiary referral center. PATIENT: Thirty-four patients diagnosed as having AN by magnetic resonance imaging between 1988 and 1995. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: The authors made a comparison between the patients' ECoG findings and the size of their tumors as determined by magnetic resonance imaging and a pure-tone audiometry (PTA). The disparity between the threshold of PTA and the detective threshold of compound action potential (CAP) or that of the cochlear microphonics (CM) was calculated. When the threshold of the PTA was worse than the detective threshold of the CAP or the CM, the disparity was regarded as indicating a hearing loss of retrocochlear origin. RESULTS: There was no correlation found between tumor size and the detective threshold of CAP or CM. Disparity was found to correlate with tumor size. CONCLUSIONS: These findings seem to indicate that retrocochlear damage in AN increases parallel to the growth of the tumor and that retrocochlear damage can be detected by the ECoG before surgery.

Adult↗

PubMed1999

The effect of sevoflurane and isoflurane anesthesia on interictal spike activity among patients with refractory epilepsy.

UNLABELLED: The electrophysiologic effects of sevoflurane are not well characterized in humans. Among patients with refractory epilepsy, this study compared 1) electroencephalographic (EEG) interictal spike activity during wakefulness and sevoflurane anesthesia, and 2) electrocorticographically (ECoG) recorded interictal spike activity during sevoflurane and isoflurane anesthesia. We studied 12 patients undergoing insertion of subdural electrodes. Before commencing anesthesia, awake (baseline) EEG recordings were obtained. After inhaled induction, EEG interictal spike activity was evaluated during stable, normocapnic, and hypocapnic (Paco2 = 28-30 mm Hg), sevoflurane anesthesia administered at 1.5 times the minimum alveolar anesthetic concentration (1.5 MAC). Immediately after surgery, ECoG recordings were obtained from subdural electrodes during 1) 1.5 MAC isoflurane, 2) 0.3 MAC isoflurane, and 3) 1.5 MAC sevoflurane anesthesia. EEG spike frequency increased in all patients during sevoflurane anesthesia compared with awake recordings (P = 0.002). Compared with 0.3 MAC isoflurane anesthesia, ECoG interictal spike frequency was higher in all patients during 1.5 MAC sevoflurane anesthesia (P = 0.004) and in 8 of 10 patients during 1.5 MAC isoflurane anesthesia (P = 0.016). Under sufficiently rigorous conditions, both sevoflurane and isoflurane can provoke interictal spike activity at near burst-suppression doses. This property is more prominent with sevoflurane than isoflurane. IMPLICATIONS: The results of this study suggest that the capacity to modulate neuroexcitability is a dose-dependent feature of volatile anesthetics that is manifested most prominently at near burst-suppression doses (i.e., 1.5 times the minimum alveolar anesthetic concentration) and is minimal or absent at low doses.

Adolescent↗

PubMed2000

Oral estramustine and cyclophosphamide in patients with metastatic hormone refractory prostate carcinoma: a phase II study.

BACKGROUND: Nearly all cases of metastatic prostate carcinoma progress, after hormonal ablation, to a hormone refractory status. To the authors' knowledge no standard chemotherapy for patients with hormone refractory prostate carcinoma (HRPC) exists. In a prospective study, the efficacy and toxicity of an oral combination of estramustine and cyclophosphamide were evaluated. METHODS: Between March 1996 and April 1998, 32 consecutive patients (median age 74 years; range, 53-84 years) with metastatic HRPC were treated with oral estramustine (10 mg/kg/day) and oral cyclophosphamide (2 mg/kg/day) for 14 days every 28 days. Inclusion criteria were previous complete androgen blockade, antiandrogen withdrawal evaluation, and clinical or biochemical disease progression. Response assessment was based on a decrease > or =50% in the prostate specific antigen (PSA) level associated with improvement (or no worsening) in Eastern Cooperative Oncology Group (ECOG) performance status (PS) and relief of bone pain (if present). RESULTS: All patients were evaluable for efficacy and toxicity. PSA levels decreased by at least 50% in 14 patients (43.7%) (95% confidence interval, 26.5-60.9), remained stable in 12 patients (37.5%), and rose in 6 patients (18.8%). ECOG PS was 0 in 5 of 14 patients, improved from 1 to 0 in 7 patients, and remained unchanged in 2 patients. Bone pain, present in 8 of 14 patients, disappeared in 7 and was partially relieved in 1. The median duration of response was 30 weeks (range, 8-88+ weeks). An objective partial response was obtained in two cases. Toxicity was mild and mainly gastrointestinal (World Health Organization [WHO] Grade 1). No cases of WHO Grade 3-4 hematologic toxicity occurred. CONCLUSIONS: The oral combination of estramustine and cyclophosphamide appears to be safe and effective in patients with HRPC. In responding patients its use shows a clinical benefit in terms of improvement of ECOG PS and pain control.

Administration, Oral↗

PubMedDate not supplied

Adjuvant high-dose interferon alfa-2b in patients with high-risk melanoma.

We performed an analysis of toxicity and survival in stage III melanoma patients receiving adjuvant interferon alfa-2b (IFN). This was a retrospective single-arm analysis of 40 patients with stage III melanoma who received (IFN) administered at maximum tolerated doses of 20 mU/m2/day intravenously (i.v.) for 1 month and 10 mU/m2 three times per week subcutaneously (s.c.) for 48 weeks. Toxicity in our series is comparable to that experienced in the Eastern Cooperative Oncology Group (ECOG) 1684 trial, except for higher rates of dose-limiting myelosuppression and hepatotoxicity. All 40 patients experienced constitutional symptoms, but only 14/40 (35%) experienced grade 3 to 4 symptoms. Of the 40 patients, 36 (90%) experienced neurologic symptoms, but only seven (17.5%) experienced grade 3 to 4 neurotoxicity. Two patients stopped treatment because of severe psychiatric symptoms; one patient attempted suicide, and a psychosis developed in another. Thirty-nine (97.5%) patients experienced myelosuppression; 31 (77.5%) developing grade 3 to 4 myelosuppression. Hepatotoxicity was evident in 39 (97.5%) patients, and 26 (65%) experienced grade 3 to 4 hepatotoxicity. Three patients (7.5%) experienced mild renal toxicity. At a median follow-up of 27 months from initiation of therapy, there have been 19 relapses (47.5% disease-free survival [DFS]) and 10 deaths (75% OS) resulting from progression of disease. The DFS compares with the treatment arm in ECOG 1684 at 27 months, but overall survival is higher in our series of patients at the same time point. In a single program setting, IFN can be administered with similar side effects and outcome profiles seen in multi-institutional studies. Modifications in the induction regimen resulted in notably higher hematologic and hepatic toxicities but did not preclude administering further therapy and did not result in increased attrition rate among patients: only nine patients (22.5%) had their treatment stopped as a result of IFN-related toxicity. In comparison, 26% of patients had to have their treatment discontinued because of toxicity in ECOG 1684.

Adult↗

PubMed2000

[An anesthetic experience of epileptic focus resection in a nine month-old girl under monitoring by electrocorticography].

We report a successful electrocorticography (ECoG) monitoring for a epileptic cortical focus resection in a 9-month-old girl with uncontrollable epileptic seizures. Anesthesia was induced and maintained with nitrous oxide, oxygen, and sevoflurane with vecuronium. After the craniotomy, ECoG monitoring was used to locate the epileptic cortical lesion. During the procedure of subpial resection and gyrectomy, ECoG was repeatedly recorded. It was necessary to maintain adequate depth of anesthesia throughout the procedure to clarify the epileptic waves. For this purpose, sevoflurane (2.5%) with and oxygen (97.5%) under controlled-hyperventilation (PaCO2 30 mmHg), was useful for monitoring the epileptic seizure wave from cortical focuses properly.

Anesthesia, Inhalation↗

PubMed2001

The role of surgery and postoperative chemoradiation therapy in patients with lymph node positive esophageal carcinoma.

BACKGROUND: Patients who have undergone resection for lymph node positive esophageal carcinoma are at high risk of disease recurrence and early death. The role of postoperative adjuvant therapy in this population needs to be determined. METHODS: A retrospective review of all patients with resected esophageal carcinoma between 1991 and 1997 was performed. Lymph node positive (N1) patients who received concurrent or sequential postoperative radiotherapy (50 grays) and chemotherapy (cisplatin, 5-fluorouracil with or without epirubicin) were compared with N1 patients who underwent surgery alone. The disease free and overall survival rates were calculated using the Kaplan-Meier method, and groups were compared with the log-rank test. Prognostic variables were entered into a Cox regression model controlling for age, weight loss, T status, Eastern Cooperative Oncology Group (ECOG) score, and treatment received. RESULTS: A total of 165 patients were reviewed: Twenty-eight N1 patients underwent surgery alone (S group), and 38 N1 patients underwent surgery and received postoperative chemoradiation therapy (CRT group). Preoperative risk factors, tumor characteristics, ECOG scores, and lengths of hospital stay were similar. The disease free survival rates were similar (S group, 10.6 months; CRT group, 10.2 months), although the S group had more local disease recurrences (S group, 35%; CRT group, 13%; P = 0.09). The overall survival rate according to the Kaplan-Meier analysis showed a significant survival advantage with postoperative CRT radiation (log-rank test; P = 0.001). The median overall survival for the CRT group was 47.5 months, which was significantly longer than that of the S group (14.1 months). The ECOG score, T status, and treatment received all were found to influence survival significantly on univariate analysis. In the multivariate model, postoperative CRT was a predictor of survival (P = 0.007; risk ratio for mortality, 0.35; 95% confidence interval, 0.16-0.76) and was correlated with a significantly decreased risk of death in patients with lymph node positive, resected esophageal carcinoma. CONCLUSIONS: Postoperative CRT appears to prolong survival in patients with lymph node positive, resected esophageal carcinoma.

Aged↗

PubMed1999

[Surgical treatment of frontal lobe epilepsy--40 cases].

OBJECTIVE: To compare the methods and outcome of the treatment of frontal lobe epilepsy (FLE). METHODS: We combined such techniques, as intraoperative electrocorticography (ECoG), corpus callostomy(CCS), and multiple subpial transection(MST) to improve the surgical results. When preoperative semiology suggested the involvement of the bilateral frontal lobe or ECoG detected bilaterally synchronized epileptic discharged, anterior corpus callosotomy was performed before the main surgical procedure. MST was applied to the unresectable motor or involved speech zone. This technique was also useful for the treatment of widely disseminated epileptic zone. Satisfactory results were obtained in surgical treatment of FLE. RESULTS: One month after operation, most patients were free from seizure. No severe complications and operative death occurred. Follow up lasted for 0.5 to 3 years(mean 2.5 years). Seizure free was noted in 19 patients(47.5%), seizure attack less than 3 times per year or no real attack in 11(27.5%), significant reduction of seizure attack in 6(15%); and no change in 4 (10%). The total effective rate was 90%. CONCLUSION: Indicated by ECoG, combined resection with corpus callosotomy or multiple subpial transection is an effective method for FLE.

Adolescent↗

PubMed2002

[Magnetoencephalographic localization of multiple seizure foci for surgical treatment of intractable frontal lobe epilepsy: confirmation with intra-operative electrocorticography].

A successfully treated case of intractable FLE, of which preoperative magnetoencephalography (MEG) provided multiple spike localization and intraoperative corticogram (ECoG) confirmed the resection area. A 22-year-old male patient, with a history of subdural abscess at the age of 14 years, had suffered frequent simple (SPSs) and complex partial seizures (CPSs) and falling attacks since the age of 16 years. Although he underwent corpus callosotomy at the age of 17 years, additional surgical treatment was considered because of intractable and more frequent SPSs and CPSs. Magnetic resonance (MR) imaging demonstrated diffuse lesions in the right frontal lobe. Although, both interictal and ictal electroencephalography (EEG) failed to show focal epileptogenic localization, interictal MEG localized several clusters over the multiple anatomical lesions in the right prefrontal and frontal opercular regions. The patient underwent right fronto-temporal craniotomy, and anterior frontal lobectomy, followed by lesionectomy of the premotor area based on the intraoperative ECoG findings. The ECoG localized frequent spike discharges over the right prefrontal, frontal operculum and premotor cortices, which showed good correspondence with the MEG findings. MEG can be a useful noninvasive method for presurgical evaluation of intractable FLE.

Adult↗

PubMedDate not supplied

Electrocortical power spectrum changes induced by microinfusion of corticotropin-releasing factor into the locus coeruleus in rats.

Rat corticotropin-releasing factor (CRF) microinfused unilaterally or bilaterally into the locus coeruleus (LC) of awake, chronically cannulated rats produced a dose-dependent ECoG desynchronization and behavioral activation. ECoG spectra analysis revealed a significant decrease of total voltage power and of 0.25-3 and 3-6 Hz frequency bands. These effects were prevented by a pretreatment into the same site with alpha-hCRF, a selective antagonist at CRF receptors and by alprazolam, a benzodiazepine derivative. In conclusion, the present results indicate that CRF produces its behavioral and ECoG activating effects by interaction with specific receptors located on LC neurons.

Alprazolam↗

PubMedDate not supplied

Delta opioid receptors mediate seizures produced by intrahippocampal injection of ala-deltorphin in rats.

The effects of the selective delta opioid receptor agonist, ala-deltorphin, microinfused into the dorsal hippocampus or into the locus coeruleus, on the electrocorticographic (ECoG) activity continuously quantified in its spectrum were studied in rats. The microinjection into the dorsal hippocampus of ala-deltorphin (0.03, 0.3 and 1.0 nmol) produced dose-dependent motor and ECoG epileptogenic disorders. The microinfusion of similar doses of ala-deltorphin into the locus coeruleus did not evoke motor and ECoG changes. Intrahippocampal injection of naltrindole (10 and 20 pmol) antagonized the epileptogenic effects induced by ala-deltorphin; also naloxone (20 and 50 pmol) was able to prevent the effects induced by ala-deltorphin, although with a minor potency. In conclusion, the present experiments show that ala-deltorphin is a useful tool to characterize central opioid effects mediated by delta receptors in the brain and suggest that the stimulation of this subtype of receptors in the hippocampus is responsible for epileptogenic effects of opiates.

Animals↗

PubMed2003

Tyrosinated alpha-tubulin changes following epileptogenic and non-epileptogenic lesions in rat brain cortex.

The expression of the tyrosinated isoform of alpha-tubulin was monitored in rat frontal cortex, in order to investigate the neuronal plasticity changes occurring either in a mirror focus or in a deafferented area. A mirror focus was triggered by epidural implantation of a cobalt gelatin disk in the contralateral left somatosensory area (group one). A deafferented area was obtained by surgical removal of the left frontal cortex (group two). All animals including controls underwent EcoG recordings immediately before killing (45, 60, 90 days post surgery). The right frontal cortex was removed from all the animals and processed with Western blot method. EcoG recordings revealed a paroxysmal activity in epileptic rats, whereas in rats with frontal deafferentation and controls, EcoG activity was normal. A significant increase in tyrosinated alpha-tubulin expression was detected both in the mirror focus (group one) and the "non-epileptic" deafferented frontal cortex (group two) in comparison with controls (group three). The transcallosal deafferentation, which is involved in both epileptogenic and non-epileptogenic lesions, is supposed to play a role in the mechanism responsible for the plasticity responses recorded in the cortical areas studied.

Action Potentials↗

PubMedDate not supplied

[Lengthy unilateral EEG changes in alert rabbits after a spreading single depressed wave].

Effects of a single wave of the cortical spreading depression (SD) on the ECoG of a waking rabbit was studied with chronically implanted intracortical calomel and silverball epidural electrodes. DC potential shifts and integral electrical activity were recorded monopolary in reference to a nasal-bone electrode. ECoG spectral analysis (FFT) showed that an SD wave was accompanied by a suppression of the neocortical activity in a broad frequency range (0.25-80 Hz). However, the SD-related ECoG depression was a rather short phenomenon (5-7 min) as compared to a following rebound effect, i.e., persistent (1.5-2 h) unilateral exaltation of bioelectrical activity. The spectral power in the delta (6-14 fold) and beta bands (2-6-fold) increased, whereas the high-frequency activity (40-80 Hz) remained suppressed. Similar changes in the contralateral neocortex were poorly pronounced or absent; this resulted in a strong interhemispheric asymmetry. It is suggested that (1) exaltation of the delta activity after SD wave is related not only to a dendrite swelling and changes in the extracellular space structure but to increase in synaptic transmission efficiency, probably, by the type of anoxic potentiation, (2) activation of some subcortical structures by the mechanism of their release from the inhibitory neocortical control is an additional factor of the augmentation of the delta and spindle-like beta activity after an SD wave, and (3) the long-term attenuation of the high-frequency gamma activity is a result of its strong suppression during the SD and its reciprocal relations with the exalted delta activity.

Animals↗

PubMedDate not supplied

Panic-like attack induced by microinfusion into the locus coeruleus of antagonists and inverse agonists at GABAA-receptors in rodents.

The microinfusion of drugs inhibiting GABA-ergic transmission into the locus coeruleus (LC) of rats and mice produced a dramatic pattern of behavioural stimulation accompanied by marked electrocortical (ECoG) desynchronization. In rats, unilateral microinfusion into the LC of bicuculline (0.5-4 pmol) produced dose-dependent behavioural stimulation culminating in a panic-like attack, ECoG desynchronization and marked changes in ECoG spectrum power. These effects were prevented by a pretreatment into the same site with muscimol. Similarly, in mice, the microinfusion of ethyl-beta-carboline-3-carboxylate (beta-CCE, 4.1 nmol) into the LC of C57BL/6 mice produced an intense state of behavioural stimulation accompanied by intense stereotyped movements and increased excitability to external stimuli; these effects were prevented by prior microinfusion of diazepam or flumazenil into the same site. In conclusion, the present experiments show that in rodents drug manipulations leading to a decrease in the activity of GABA-benzodiazepine receptor complex in the LC are responsible for the occurrence of panic-like attacks.

Animals↗

PubMed1991

Localization of partial epilepsy using magnetic and electric measurements.

Dipole methods applied to brain electric and magnetic fields have made several significant advances in investigation of epilepsy and sensorimotor cortex. The magnetoencephalogram (MEG) and the MEG-electroencephalogram (EEG) combination have contributed substantially. The MEG-EEG combination has shown a mean accuracy of somatosensory evoked response (SER) localization of the central fissure similar to electrocorticography (ECoG), resolution of ambiguity in ECoG of alternative configurations of hand sensorimotor cortex, and resolution of ambiguity of the causes of the difference between EEG and ECoG map patterns. MEG has shown simple dipolar maps of the temporal lobe interictal spike, localization estimates with about 6 mm error, and spatial separation of propagating multiple sources. MEG and EEG have shown a new neocortical propagation pathway in the temporal lobe, noninvasive estimates of the area of the spike focus, and complementary detection sensitivity. Application of spatiotemporal multiple dipole modeling in the simplest field using MEG has given a realistic quantification of spike zones. MEG and EEG have shown simple dipolar patterns for seizure origin, suggesting focality of some frontal seizures, and appears to increase EEG utility. Improved accuracy may result from a combined methodology including MEG and EEG. Dipole methods have potential utility as a noninvasive diagnostic procedure in epilepsy.

Brain Mapping↗