Brain parenchyma apparent diffusion coefficient alterations associated with experimental complex partial status epilepticus

Righini, Andrea; Pierpaoli, Carlo; Alger, Jeffry R.; Chiro, Giovanni Di

doi:10.1016/0730-725x(94)92027-3

Cited by 117 publications

(78 citation statements)

References 23 publications

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“…By using the experimental model of kainic acidinduced status epilepticus in rats, it has been shown that postictal ADC was decreased in the piriform cortex, hippocampus, and amygdala for 24-72 h and normalized within 9 days (7,8). The ADC changes were closely correlated with the presumed area of seizure onset and the resulting histopathologic changes.…”

Section: Discussionmentioning

confidence: 76%

“…DWI has demonstrated great utility for the early identification of cerebral ischemia both in animal models (3) and in humans (43). Data from animal models of focal seizures (6)(7)(8)(9)(10) and from a case report on one patient during status epilepticus (1 l) suggest that DWI may be a sensitive tool for the localization of active epileptogenic foci. In this study, we report on the correlation between electrocorticographic (ECoC) seizure activity and focal DWI changes in a patient with left focal motor status epilepticus.…”

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confidence: 99%

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Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy

et al. 1999

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Summary:Purpose: Diffusion-weighted MR imaging (DWI) has been used for the early diagnosis of acute ischemic lesions in humans and in animal models of focal status epilepticus. We hypothesized that DWI may be a sensitive, noninvasive tool for the localization of the epileptogenic area during the periictal period.Methods: A periictal DWI study was performed on a 35-year-old patient during focal status epilepticus with repetitive prolonged focal motor seizures originating from a lesion in theright frontal lobe. DWI results were analyzed visually and by calculating apparent diffusion coefficient (ADC) maps.Results: On DWI, a single area of signal increase (decrease in ADC) was found in the region of focal electrocorticographic seizures that was mapped intraoperatively .Conclusions: Ictal/postictal DWI may be a useful technique for seizure localization in patients with lesional epilepsy. Key Words: Diffusion-weighted magnetic resonance imagingSeizures-Epilepsy . Diffusion-weighted imaging (DWI) is a noninvasivetechnique that allows the in situ measurement of water diffusion predominantly within the interstitial space (1,2). DWI has demonstrated great utility for the early identification of cerebral ischemia both in animal models (3) and in humans (43). Data from animal models of focal seizures (6-10) and from a case report on one patient during status epilepticus (1 l) suggest that DWI may be a sensitive tool for the localization of active epileptogenic foci. In this study, we report on the correlation between electrocorticographic (ECoC) seizure activity and focal DWI changes in a patient with left focal motor status epilepticus. CASE REPORTA 35-year-old right-handed woman developed left focal motor seizures (involving left arm and face) in 1985 and subsequently was diagnosed with a right frontal glioma. She underwent resection and continued to have rare seizures. She had been seizure free for 18 months ~ ~~

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Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy

et al. 1999

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“…In recording ictal SPECTs, the interictal SPECT is helpful in determining the extent of blood flow changes between the two conditions (83). Recent data from animal models and case reports on patients suggest that diffusionweighted magnetic resonance imaging (DWI) may be an additional noninvasive technique for localization of the epileptogenic zone (84)(85)(86)(87), and preliminary data suggest that it may be particularly helpful in patients with lesional epilepsy (88). Surface EEG is characterized by a higher incidence of interictal spikes compared to HS (89).…”

Section: General Considerationsmentioning

confidence: 99%

Temporal Lobe Epilepsy: When Are Invasive Recordings Needed?

2000

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Summary:Temporal lobe epilepsy (TLE) is the most common type of medically intractable partial epilepsy amenable to surgery. In the majority of cases, the underlying pathology in temporal lobe epilepsy is mesial temporal sclerosis (MTS). Whereas historically invasive recordings were required for most epilepsy surgeries, indications have dramatically changed since the introduction of high-resolution MRI, which uncovers structural lesions in a high percentage of cases. No invasive recordings are required to perform a temporal lobectomy in patients with intractable epilepsy who have structural imaging suggesting unilateral MTS and concordant interictal and ictal surface EEG recordings, functional imaging, and clinical findings. Invasive testing is needed if there is evidence of bitemporal MTS on structural imaging and/or electrophysiologically, and additional information from functional imaging, neuropsychology, and the intracarotid amobarbital (Wada) test also does not help to lateralize the epileptogenic zone. Depth electrodes can be particularly helpful in this setting. However, no surgery is indicated, even without invasive recordings, if bitemporalindependent seizures are recorded by surface EEG and all additional testing is inconclusive. Other etiologies of TLE such as a tumor, vascular malformation, encephalomalacia, or congenital developmental abnormality account for about 30% of all patients who undergo epilepsy surgery. Epilepsy surgery is indicated after limited electrophysiologic investigations if neuroimaging and electrophysiology converge. However, approaches for resection in lesional temporal lobe epilepsy vary among centers. Completeness of resection is crucial and invasive recordings may be needed to guide the resection by mapping eloquent cortex and/or to determine the extent of the non-MRI-visible epileptogenic area. Specific approaches for the different pathologies are discussed because there is evidence that the relationship between the lesions visible on MRI and the epileptogenic zone varies among lesions of different pathologies, and therefore variable surgical strategies must be applied. Key Words: Temporal lobe-Epilepsy-Electrodes, implanted-Magnetic resonance imaging-Brain neoplasms. HISTORICAL PERSPECTIVES: INVASIVE RECORDINGS FOR EPILEPSY SURGERYThe pioneers of epilepsy surgery utilized clinical findings and seizure semiology to localize the epilepsy and to guide the neurosurgical intervention. This is illustrated by Victor Horsley's first neurosurgical intervention at Queens Square in 1886. The patient was a 22-year-old Scotsman who had a posttraumatic epilepsy. He had very frequent focal motor seizures characterized by a clear march. The diagnosis of "scar involving the hinder end of the superior frontal sulcus" was made according to the ictal semiology and the seizures stopped after surgical removal of the scar. Apart from semiologic analysis of the seizures, additional information was obtained by intraoperative cortical stimulations to reproduce the patient's seizure semiology and to ...

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“…15) Similarly, increased intensity and decreased apparent diffusion coefficient values which reflect cytotoxic edema were observed in the epileptogenic area of animal models. 18) Increased intensity could also be explained by acidosis and the breakdown in the blood-brain barrier, and subsequent vasogenic edema caused by regional hyperperfusion and increased vascular permeability seen in clinical cases of partial seizures. 8,19,21) In humans with partial status epilepticus, vasogenic edema is considered to be the most probable mechanism for reversible changes seen on MR imaging.…”

Section: Discussionmentioning

confidence: 99%

Transient Occipitotemporal Subcortical Diffusion-Weighted Magnetic Resonance Imaging Abnormalities Associated With Status Epilepticus-Case Report-

Tucker

Miyake

Tsuji

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 30-year-old man presented with a generalized seizure manifesting as decreased consciousness. Diffusion-weighted magnetic resonance imaging showed transient areas of high intensity in the gray and subcortical white matter of the left occipital and temporal lobes. The lesions did not reflect the vascular territories. After a period of over 2 weeks, his consciousness level improved associated with reduced intensity of the abnormal areas. These findings suggest that seizure induced reversible cytotoxic and vasogenic edema. Transient diffusion-weighted magnetic resonance imaging abnormalities may be associated with generalized seizures and the intensity may reflect the clinical condition.

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Brain parenchyma apparent diffusion coefficient alterations associated with experimental complex partial status epilepticus

Cited by 117 publications

References 23 publications

Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy

Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy

Temporal Lobe Epilepsy: When Are Invasive Recordings Needed?

Transient Occipitotemporal Subcortical Diffusion-Weighted Magnetic Resonance Imaging Abnormalities Associated With Status Epilepticus-Case Report-

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