| Ictogenesis and symptomatogenesis of gelastic seizures in hypothalamic hamartomas: an ictal SPECT study. | |
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MedLine Citation:
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PMID: 20887368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To topographically localize the ictogenic zone within hypothalamic hamartomas (HHs) and the symptomatogenic zone for gelastic seizure (GS), we analyzed data from both interictal and ictal single photon emission computed tomography (SPECT). METHODS: Ictal SPECT was performed immediately after GS onset in 21 patients with HH (aged 2-36 years, mean 13.8 years) who underwent stereotactic radiofrequency thermocoagulation (SRT). SPECT data were statistically analyzed by means of subtraction ictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM) and statistical parametric mapping (SPM). Topographic localization of ictal hyperperfusion areas was evaluated. RESULTS: SISCOM obtained in 27 studies demonstrated ictal hyperperfusion in the HH interface zone in 16 studies of 13 patients (hot HH group). In these patients, HHs were significantly larger than those without hyperperfusion of HH in 11 studies of 8 patients (21.4 ± 10.3 vs. 12.3 ± 7.3 mm in diameter, p < 0.05, t-test). In all patients and in the hot HH group, SPM group analysis of individual differences between interictal and ictal data revealed significantly (p < 0.001) hyperperfused areas in the ipsilateral hypothalamus, mediodorsal (MD) nucleus of the thalamus and putamen, bilateral pontine tegmentum, and contralateral inferior semilunar lobule of the cerebellum. There was no hyperperfusion in the mammillothalamocingulate pathway. DISCUSSION: The present study confirmed that ictogenesis occurs in the HH interface zone, which should accordingly be the target for SRT. We suggest that a thalamopontocerebellar circuit plays an important role for stereotypical and automatic symptomatogenesis of GS and that the hypothalamus and MD nucleus of the thalamus are potentially involved in epileptic encephalopathy. |
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Authors:
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Shigeki Kameyama; Hiroshi Masuda; Hiroatsu Murakami |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-30 |
Journal Detail:
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Title: Epilepsia Volume: 51 ISSN: 1528-1167 ISO Abbreviation: Epilepsia Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-27 Completed Date: 2011-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2983306R Medline TA: Epilepsia Country: United States |
Other Details:
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Languages: eng Pagination: 2270-9 Citation Subset: IM |
Copyright Information:
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Wiley Periodicals, Inc. © 2010 International League Against Epilepsy. |
Affiliation:
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Department of Functional Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan. kameyama@masa.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Brain Mapping Child Child, Preschool Cysteine / analogs & derivatives, diagnostic use Dominance, Cerebral / physiology Electroencephalography Epilepsies, Partial / physiopathology*, radionuclide imaging*, surgery Female Hamartoma / physiopathology, radionuclide imaging, surgery Humans Hypothalamic Diseases / physiopathology, radionuclide imaging, surgery Hypothalamus / physiopathology, radionuclide imaging, surgery Image Processing, Computer-Assisted* Imaging, Three-Dimensional* Magnetic Resonance Imaging* Male Organotechnetium Compounds / diagnostic use Radiosurgery Regional Blood Flow / physiology Signal Processing, Computer-Assisted Software Subtraction Technique* Tomography, Emission-Computed, Single-Photon* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Organotechnetium Compounds; 0/technetium Tc 99m bicisate; 52-90-4/Cysteine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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