Document Detail


Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus.
MedLine Citation:
PMID:  15743871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diffusion-weighted MRI (DWI) and perfusion MRI (PI) have been mainly applied in acute stroke, but may provide information in the peri-ictal phase in epilepsy patients. Both transient reductions of brain water diffusion, namely a low apparent diffusion coefficient (ADC), and signs of hyperperfusion have been reported in experimental and human epilepsy case studies. We studied 10 patients with complex partial status epilepticus (CPSE) with serial MRI including DWI and PI. All patients showed regional hyperintensity on DWI, and a reduction of the ADC in (i) the hippocampal formation and the pulvinar region of the thalamus (six out of 10 patients), (ii) the pulvinar and cortical regions (two out of 10), (iii) the hippocampal formation only (one out of 10), and (iv) the hippocampal formation, the pulvinar and the cortex (one out of 10). In all patients a close spatial correlation of focal hyperperfusion with areas of ADC/DWI change was present. In two patients hyperperfusion was confirmed in additional SPECT (single photon emission computed tomography) studies. All patients received follow-up MRI examinations showing partial or complete resolution of diffusion and perfusion abnormalities depending on the length of the follow-up interval. The clinical course, EEG and SPECT results all indicate that MRI detected changes related to prolonged epileptic activity. Combined PI and DWI can visualize haemodynamic and tissue changes after CPSE in the hippocampus, thalamus and affected cortical regions.
Authors:
Kristina Szabo; Annkathrin Poepel; Bernd Pohlmann-Eden; Jochen Hirsch; Tobias Back; Oliver Sedlaczek; Michael Hennerici; Achim Gass
Publication Detail:
Type:  Journal Article     Date:  2005-03-02
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  128     ISSN:  1460-2156     ISO Abbreviation:  Brain     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-18     Completed Date:  2005-09-13     Revised Date:  2010-06-10    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  1369-76     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Universit?tsklinikum Mannheim, University of Heidelberg, Mannheim, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain / radionuclide imaging
Diffusion Magnetic Resonance Imaging / methods
Electroencephalography
Female
Follow-Up Studies
Hippocampus / pathology
Humans
Male
Middle Aged
Status Epilepticus / pathology*,  physiopathology,  radionuclide imaging
Tomography, Emission-Computed, Single-Photon
Comments/Corrections
Comment In:
Epilepsy Curr. 2006 Jul-Aug;6(4):121-3   [PMID:  17260032 ]

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