Arterial spin-labeling magnetic resonance imaging for diagnosis of late seizure after stroke

Miyaji, Yoshiyuki; Yokoyama, Mutsumi; Kawabata, Yuichi; Joki, Hideto; Kushi, Yuji; Yokoi, Yasutaka; Sasame, Jo; Seki, Shunsuke; Mori, Kentaro; Kamide, Tomoya; Tamase, Akira; Shima, Hiroshi; Nomura, Motohiro; Kitamura, Yoshihisa; Tanaka, Fumiaki

doi:10.1016/j.jns.2014.01.026

Cited by 20 publications

(15 citation statements)

References 22 publications

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“…In epilepsy, the series of patients studied with ASL include mostly subjects with mesial temporal lobe epilepsy [7,8]. Overall, these studies show increased perfusion during the peri-ictal period [9][10][11][12] and decreased perfusion during the post-ictal period [9,11,13], and these findings are globally concordant with electrophysiological studies, PET and/or singlephoton emission computed tomography (SPECT). Only individual cases with neocortical epilepsy have been reported [9,11,[13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 69%

Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug‐resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG‐PET

Sierra-Marcos¹,

Carreño²,

Setoaín

et al. 2015

Euro J of Neurology

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Section: Introductionmentioning

confidence: 69%

Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug‐resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG‐PET

Sierra-Marcos¹,

Carreño²,

Setoaín

et al. 2015

Euro J of Neurology

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“…It is therefore necessary to be aware that at any time after stroke, any type and location of stroke may cause a non-convulsive late seizure. As we recently reported (18), the demonstration of increased cortical perfusion by arterial spin-labeling MRI, which does not require a contrast agent, might be helpful in the early diagnosis of late seizures in the emergency department.…”

Section: Discussionmentioning

confidence: 86%

Late Seizures after Stroke in Clinical Practice: The Prevalence of Non-convulsive Seizures

et al. 2017

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Objective The prevalence of the non-convulsive type of late seizure after stroke is unknown. The aim of the present study was to clarify the characteristics of late seizure in clinical practice, mainly focusing on the prevalence of non-convulsive seizure. Methods A total of 178 consecutive patients who were admitted and diagnosed with late seizure after stroke were retrospectively enrolled, and the data of 127 patients for whom the complete seizure was observed by a bystander were analyzed. Clinical information was obtained from the medical records and nursing notes. Results A non-convulsive seizure was observed in 37 patients (29%). A focal seizure and its secondary generalization accounted for 79% of the seizure types. Status epilepticus was observed in 60 patients (47%), including 11 patients (9%) without convulsion. The patients with non-convulsive seizures were significantly younger than those with convulsive seizures, but there were no other significant differences between the two groups with respect to sex, classification or the lesion of stroke. Conclusion There was a high rate of non-convulsive seizures in patients with late seizure after stroke. A non-convulsive seizure may be caused by any type or location of preceding stroke. More attention is needed in the differential diagnosis of neurological deterioration after stroke.

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“…Arterial spin labeling (ASL) is a completely non-invasive and repeatable perfusion magnetic resonance image that uses magnetically-labeled water in the blood as an endogenous tracer. Recent studies have demonstrated that combined use of a perfusion image with ASL and diffusion-weighted imaging (DWI) can provide valuable information on the circulatory and metabolic consequences associated with epilepsy during ictal [ [1] , [2] , [3] , [4] , [5] , [6] , [7] ] or periictal (or postictal) periods [ 2 , [8] , [9] , [10] , [11] , [12] ].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic state of periictal hyperperfusion revealed by arterial spin-labeling perfusion MR images with dual postlabeling delay

et al. 2018

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BackgroundMagnetic resonance imaging (MRI), including perfusion MRI with arterial spin labeling (ASL) and diffusion-weighted imaging (DWI), are applied in the periictal detection of circulatory and metabolic consequences associated with epilepsy. Although previous report revealed that prolonged ictal hyperperfusion on ASL can be firstly detected and cortical hyperintensity of cytotoxic edema on DWI secondarily obtained from an epileptically activated cortex, the hemodynamic state of the periictal hyperperfusion has not been fully demonstrated.Methods: study-1We retrospectively analyzed the relationship between seizure manifestations and the development of periictal MRI findings, in Case 1 with symptomatic partial epilepsy, who underwent repeated periictal ASL/DWI examination for three epileptic ictuses (one examination for each ictus). Study-2: We evaluated the hemodynamic state of periictal hyperperfusion with the ASL technique using a dual postlabeling delay (PLD) of 1.5 and 2.5 s in nine patients, according to the presence or absence of the localized epileptogenic lesion (EL) on conventional 3 T-MRI, who were divided into Group EL+ (six patients) and Group EL− (three patients).ResultsStudy-1 confirmed that the stratified representation of the periictal MRI findings depends on the time interval between the ictal cessation and MRI examination in addition to the magnitude and duration of the epileptic activity. In Study-2, two types of periictal hyperperfusion were noted. In all six Group EL+ patients, periictal ASL findings showed “fast flow type”. Markedly increased ASL signals were noted at the epileptically activated cortex, having a tight topographical relationship with EL, on ASL with a PLD of 1.5 s, which is decreased on ASL with a PLD of 2.5 s. In all three Group EL− patients, periictal ASL findings showed “gradual flow type”, which is characterized by gradual signal increase of the epileptically activated cortex on ASL with a PLD of 1.5 and 2.5 s.ConclusionWe confirmed that ASL hyperperfusion is superior to DWI in the periictal detection of epileptic events. ASL with dual PLD offers the ability to document two types of hemodynamics of periictal hyperperfusion.

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Arterial spin-labeling magnetic resonance imaging for diagnosis of late seizure after stroke

Abstract: ASL was able to reveal hyperperfusion and was of great diagnostic value in the peri-ictal phase of late seizure after stroke.

Cited by 20 publications

References 22 publications

Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug‐resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG‐PET

Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug‐resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG‐PET

Late Seizures after Stroke in Clinical Practice: The Prevalence of Non-convulsive Seizures

Hemodynamic state of periictal hyperperfusion revealed by arterial spin-labeling perfusion MR images with dual postlabeling delay

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