Dynamic imaging of ictal rhythmic activity using dense-array EEG

Electroencephalogram (EEG) is an important component of the pre-surgical evaluation in the treatment of medically intractable epilepsy. However, clinical EEG uses 19 to 32 electrodes that significantly limits its localization ability. Recent development of dense-array recording techniques has suggested that increased spatial sampling rate improves the accuracy of source localization. In the current study, we proposed a 76-channel EEG system for the long-term monitoring of epilepsy patients, and proposed a dynamic seizure imaging (DSI) technique to image the ictal rhythmic activity that may evolve through time, space and frequency. We tested the system in a cohort of 8 patients and our results show that the DSI estimated the seizure activity in good correlation with intracranial recordings, successful surgery outcomes and other clinical evidence. The proposed dense-array recording and DSI imaging approach enable a non-invasive but quantitative imaging of continuous seizure activity. The results suggest that DSI may potentially be useful to assist the pre-surgical evaluation in patients with intractable epilepsy.