A prospective study of diffusion weighted magnetic resonance imaging abnormalities in patients with cluster of seizures and status epilepticus

Jabeen, Shaik Afshan; Cherukuri, Pavankumar; Mridula, Rukmini; Harshavardhana, K R; Gaddamanugu, Padmaja; Sailaja, S.; Meena, A K; Borgohain, Rupam; Rani, Y. Jyotsna

doi:10.1016/j.clineuro.2017.02.013

Cited by 33 publications

(44 citation statements)

References 23 publications

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“…However, the presented 9.4‐T DTI FA maps were included primarily to shed light on the problem that, on an individual level, cellular alterations after NCSE are variable and sometimes undetectable. Given that the current first‐line tool for investigating epileptic insults is 1.5–3‐T MRI scanners and that few studies have been able to localize long‐lasting changes in the brain following NCSE, future studies may have to combine more advanced MRI methods with other imaging techniques, such as new positron emission tomography isotopes, to increase the sensitivity for seizure‐induced changes.…”

Section: Discussionmentioning

confidence: 99%

“…So far, the general clinical prediction of NCSE is that it may not give rise to long‐lasting changes in the brain. Magnetic resonance imaging (MRI), single photon emission computed tomography, and diffusion tensor imaging (DTI) of patients with ongoing NCSE have shown peri‐ictal abnormalities including regional hyperperfusion and reduced diffusion, but on follow‐up MRI most patients show complete resolution . Consequently, when considering aggressive anesthetic therapy to terminate drug‐resistant NCSE the clinical knowledge of possible brain injuries due to the NCSE per se is lacking and the treatment is mostly dependent on the underlying disease …”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI), single photon emission computed tomography, and diffusion tensor imaging (DTI) of patients with ongoing NCSE have shown periictal abnormalities including regional hyperperfusion and reduced diffusion, but on follow-up MRI most patients show complete resolution. 5,6 Consequently, when considering aggressive anesthetic therapy to terminate drug-resistant NCSE the clinical knowledge of possible brain injuries due to the NCSE per se is lacking and the treatment is mostly dependent on the underlying disease. 1 A number of experimental animal models have been utilized to study disease mechanisms of SE, with the chemical pilocarpine/kainic acid models being the most frequently used.…”

Section: Introductionmentioning

confidence: 99%

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Nonconvulsive status epilepticus in rats leads to brain pathology

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nonconvulsive status epilepticus in rats leads to brain pathology

et al. 2018

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“…Finally, in the few studies in which the authors performed a statistical comparison of SE duration in cases with and without MRI lesions, it was observed that SE duration correlated positively with the appearance of MRI alterations …”

Section: Periictal Imaging Alterations and Eegmentioning

confidence: 99%

Neuroimaging of status epilepticus

Meletti

Monti²,

Mirandola

et al. 2018

Epilepsia

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In the past 2 decades we have observed an extensive use of different neuroimaging techniques to evaluate patients with status epilepticus. Magnetic resonance imaging (MRI) in particular may show a broad spectrum of abnormalities that are either the causes or the consequences of sustained epileptic activity. Neuroimaging techniques can offer a contribution both in the clinical management of individual patients, identifying hemodynamic patterns that support the diagnosis, and also in the recognition of periictal reversible or irreversible alterations. For the future it is necessary to develop larger and prospective studies in which imaging techniques and electroencephalography (EEG) recordings are acquired closely to understand which EEG patterns are related to imaging biomarkers of neuronal damage.

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“…However, CSF levels of 14-3-3 protein and/ or tau protein are reportedly elevated in both sCJD and status epilepticus with non-prion disease. 1,2 In addition, cortical hyper-intensity in diffusion-weighted MR images (DW-MRI) is observed during the acute phases of status eplepticus 3 and CJD. Furthermore, V180I genetic CJD (gCJD) exhibits cortical-edematous hyper-intensities on DW-MRI, 4,5 which is similar to the acute phase of status epilepticus.…”

Section: Introductionmentioning

confidence: 99%

An autopsy-verified case of steroid-responsive encephalopathy with convulsion and a false-positive result from the real-time quaking-induced conversion assay

Hayashi

Iwasaki

Yagi

et al. 2017

Prion

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We report an autopsy-verified case of steroid-responsive encephalopathy with convulsion and a false-positive result from the real-time quaking-induced conversion (RT-QUIC) assay. A 61-year-old Japanese man presented with acute onset of consciousness disturbance, and convulsions, but without a past medical or family history of progressive dementia, epilepsy, or prion disease. Brain diffusion and fluid-attenuated inverted recovery MR images revealed edematous cortical hyper-intensity, which diminished after the acute phase. Steroid pulse therapy was partially effective, although he continued to have dementia with myoclonus and psychiatric symptoms, despite resolution of the consciousness disturbance. Cerebrospinal fluid (CSF) analysis revealed a normal cell count, with significantly elevated levels of 14-3-3 protein and total tau protein. In addition, prion protein in the CSF was slowly amplified by the RT-QUIC assay. PRNP gene analysis revealed methionine homozygosity at codon 129 without mutation. The patient died of sudden cardiac arrest at 3 months after the onset of symptoms. The positive result from the RT-QUIC assay led us to suspect involvement of prion disease, although a postmortem assessment revealed that he had pathological changes after convulsion, and no prion disease. This case indicates that convulsion may cause false-positive RT-QUIC results, and that a postmortem evaluation remains the gold standard for diagnosing similar cases.

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A prospective study of diffusion weighted magnetic resonance imaging abnormalities in patients with cluster of seizures and status epilepticus

Cited by 33 publications

References 23 publications

Nonconvulsive status epilepticus in rats leads to brain pathology

Nonconvulsive status epilepticus in rats leads to brain pathology

Neuroimaging of status epilepticus

An autopsy-verified case of steroid-responsive encephalopathy with convulsion and a false-positive result from the real-time quaking-induced conversion assay

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