Document Detail

Dynamic susceptibility contrast (DSC) MRI and interictal epileptiform activity in cryptogenic partial epilepsy.
MedLine Citation:
PMID:  12460254     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study the possible correlation between interictal EEG patterns and neuroradiologic data obtained by dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) in patients with partial epilepsy. METHODS: Seventeen subjects with cryptogenic partial epilepsy underwent long-term video-EEG monitoring and DSC-MRI in the same session. Ten patients had temporal lobe epilepsy (TLE) and seven, epilepsy of extratemporal origin (ExTE). MRI data were compared with EEG findings, and the accuracy of DSC-MRI was analyzed considering spiking rate (number of interictal epileptiform abnormalities, IEA/min) and type of epilepsy. RESULTS: DSC-MRI showed a relevant asymmetry in the frontal, temporal, and occipital regions in eight (47%) of 17 patients, consisting of a relative regional cerebral blood volume (rCBV) increase in these areas. Because this region corresponded to the interictal EEG focus (IEF) or to the hemisphere involved in the genesis of epileptic discharges in most patients showing a higher spiking rate, patients were classified in two groups: patients with high spiking rate (HSR, n = 9) and with low spiking rate (LSR, n = 8); the cutoff corresponded to the median value of IEA/min. The rCBV increase corresponded to the IEF or to the hemisphere involved in the genesis of epileptic discharges in seven (77.7%) of nine HSR patients. No patients with LSR showed significant asymmetries in rCBV pattern. In five of six patients with TLE-HSR (83.3%), DSC-MRI showed a relative rCBV increase concordant with IEF or hemisphere involved in the genesis of epileptic discharges; in patients with ExTE-HSR, the concordance was 66%. CONCLUSIONS: DSC-MRI is a noninvasive procedure that may provide useful additional information to lateralize and/or localize the IEF when interictal epileptiform activity is sufficiently elevated.
Fabio Placidi; Roberto Floris; Alessandro Bozzao; Andrea Romigi; Mario Tombini; Maria Elena Baviera; Francesca Sperli; Francesca Izzi; Donatella Mattia; Maria Grazia Marciani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  43     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-03     Completed Date:  2003-01-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1515-21     Citation Subset:  IM    
Neurofisiopatologia, Università di Roma Tor Vergata, Roma, Italy.
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MeSH Terms
Blood Volume / physiology
Brain Mapping
Cerebral Cortex / blood supply,  physiopathology
Dominance, Cerebral / physiology
Epilepsies, Partial / diagnosis*,  physiopathology
Epilepsy, Complex Partial / diagnosis,  physiopathology
Evoked Potentials / physiology
Image Enhancement*
Magnetic Resonance Imaging*
Middle Aged
Regional Blood Flow / physiology
Sensitivity and Specificity

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