HJAR Nov/Dec 2019

HEALTHCARE JOURNAL OF ARKANSAS  I  NOV / DEC 2019 43 non-invasively detect abnormal brain ac- tivity for patients with epilepsy, different neurodegenerative disorders like Alzhei- mer’s or Parkinson’s, or in patients with a brain tumor.” The main clinical use for MEG technol- ogy is in patients with epilepsy, Samanta said. The electrical storm that takes place in the brain of someone with epilepsy moves very quickly, and it takes various sophisticated technologies to detect the epicenter of that storm. With MEG tech- nology, doctors can precisely identify where the seizure is coming from with- out invasive monitoring. This is especially beneficial for patients who don’t respond to seizure medications. In these cases, sur- gery to remove the part of the brain where seizures are coming from is typically the next step, andMEG potentially can identify the abnormal brain area in a painless way. “In Arkansas, we have approximately 7,000 kids with pediatric epilepsy,”Saman- ta reports. “Around 2,000 of these children are unresponsive to seizure medicines, but on average, we only do around 10 epilep- sy surgeries a year. Granted, not everyone will be a candidate for epilepsy surgery, but having MEG technology allows us to identify more appropriate treatment op- tions and provide epilepsy surgery when needed.” How is a MEG Study Performed? A MEG scan is a completely painless study that involves no radiation or injec- tions. Similar to the EEG process, many patients sleep during the first half of the procedure, which lasts approximately one hour. The first part of the study is used to detect abnormal magnetic activity within the brain. The next step is to detect the part of the brain where the normal magnetic activity is generated, using a small signal, or stimulus, over the nerve. The patient is awake during this step of the procedure. “When a surgeon prepares for surgery, they need to know where the normal ar- eas of the brain are, and what the relation is to the abnormal area where the seizure is coming from,” Samanta says. “The goal is to make sure they don’t get too close to those normal areas and cause deficit after the surgery. This is also true for brain tu- mor patients who undergo a MEG scan.” How Often is MEG Technology Used? Samanta estimates that out of every 100 patients with epilepsy, approximately 20- 30 could be candidates for MEG technolo- gy. Many patients with brain tumors could also be candidates, as these are the two main approved clinical uses. However, this may change in the near future as research in other areas continues to improve. MEG scans could soon be used on a variety of patients including: • ADHD • Autism • PTSD • Bipolar disorder • Schizophrenia • Alzheimer’s • Parkinson’s • Concussion “We are finding out that MEG is much more sensitive than even a CT scan or MRI to detect abnormal brain activity after a head injury,” Samanta said. n Debopam Samanta, MD Interim Associate Professor of Pediatrics and Chief of Child Neurology Arkansas Children’s Hospital and University of Arkansas for Medical Sciences Debopam Samanta, MD, is a tenured associate professor of pediatrics and chief of child neurology (interim) at Arkansas Children’s Hospital (ACH) and University of Arkansas for Medical Sciences (UAMS) in Little Rock. Dr. Samanta earned a medical degree with Honors (2004) from Calcutta University, and a post-graduate degree in pediatrics (2007) from Delhi University in India. He pursued residency training in pediatric neurology at the University of Virginia Medical Center (2008–2013), where he received the neurology department’s highest academic achievement award in 2011. He completed clinical neurophysiology training at UAMS (2013–2014). He has been on the faculty at UAMS/ACH for the past six years, where he is the medical director of the tuberous sclerosis clinic, neurometabolic/neurogenetic clinic, and clinical neurophysiology laboratory. He also serves as the interim director of the epilepsy monitoring unit and the division of child neurology. “We are finding out that MEG is much more sensitive than even a CT scan or MRI to detect abnormal brain activity after a head injury.”