Document Detail


Patients with West syndrome whose ictal SPECT showed focal cortical hyperperfusion.
MedLine Citation:
PMID:  17071036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To clarify the mechanism of clustered spasms in West syndrome (WS), we examined ictal SPECT and EEG, as well as those during the interictal period, in three patients with symptomatic WS who had apparent focal cerebral lesions. For ictal SPECT and EEG, we monitored the patients with EEG, and as soon as we noticed the occurrence of clustered spasms clinically and electroencephalographically, [(99m)Tc]ECD was injected intravenously and flushed thoroughly with saline. In these three patients, regional cerebral blood flow (rCBF) increased during ictus and decreased during the interictal period in the area that coincided with the focal cerebral lesion recognized by CT/MRI. The ictal hyperperfusion of bilateral basal ganglia was also detected in two of the three patients. The ictal EEG showed a diffuse slow wave complex corresponding to a clinical spasm. The sharp waves that preceded the diffuse slow wave complex and the spasm appeared in the same area in which rCBF increased during ictus. None of the patients showed partial seizure before or after clustered spasms clinically or electroencephalographically during the ictal SPECT study. Secondary generalization from a cerebral focus may explain the mechanism of spasms in these patients with WS: focal cortical discharge may primarily generate clustered spasms and trigger the brainstem and basal ganglia structures to produce spasms.
Authors:
Kenji Mori; Yoshihiro Toda; Toshiaki Hashimoto; Masahito Miyazaki; Takahiko Saijo; Hiromichi Ito; Emiko Fujii; Takashi Yamaue; Yasuhiro Kuroda
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Publication Detail:
Type:  Journal Article     Date:  2006-10-27
Journal Detail:
Title:  Brain & development     Volume:  29     ISSN:  0387-7604     ISO Abbreviation:  Brain Dev.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-02-27     Completed Date:  2007-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7909235     Medline TA:  Brain Dev     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  202-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, School of Medicine, Tokushima University, Kuramoto-cho, Tokushima, Japan. moriken@clin.med.tokushima-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Cerebral Cortex / physiopathology,  radionuclide imaging*
Cerebrovascular Circulation / physiology
Child
Child, Preschool
Cysteine / analogs & derivatives
Electroencephalography / methods
Female
Humans
Infant
Infant, Newborn
Male
Organotechnetium Compounds
Spasms, Infantile / physiopathology*,  radionuclide imaging*
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
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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