FDG-PET in the diagnosis of complex partial status epilepticus originating from the frontal lobe

Stayman, Aaron; Abou‐Khalil, Bassel

doi:10.1016/j.yebeh.2011.02.001

Cited by 18 publications

(11 citation statements)

References 7 publications

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“…In this study, FDG-PET cerebral hypermetabolism similar to that described in cases of SE [5, 13, 18] was significantly more common among patients with IIC patterns fulfilling published criteria for electrographic SE or electroclinical SE than among patients with IIC patterns alone.…”

Section: Discussionsupporting

confidence: 70%

Metabolic Correlates of the Ictal-Interictal Continuum: FDG-PET During Continuous EEG

et al. 2016

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Background Ictal-interictal continuum (IIC) continuous EEG (cEEG) patterns including periodic discharges and rhythmic delta activity are associated with poor outcome and in the appropriate clinical context, IIC patterns may represent “electroclinical” status epilepticus (SE). To clarify the significance of IIC patterns and their relationship to “electrographic” SE, we investigated FDG-PET imaging as a complementary metabolic biomarker of SE among patients with IIC patterns. Methods A single-center prospective clinical database was ascertained for patients undergoing FDG-PET during cEEG. Following MRI-PET co-registration, the maximum standardized uptake value in cortical and subcortical regions was compared to contralateral homologous and cerebellar regions. Consensus cEEG review and clinical rating of etiology and treatment response were performed retrospectively with blinding. Electrographic SE was classified as discrete seizures without interictal recovery or >3-Hz rhythmic IIC patterns. Electroclinical SE was classified as IIC patterns with electrographic and clinical response to anticonvulsants; clonic activity; or persistent post-ictal encephalopathy. Results Eighteen hospitalized subjects underwent FDG-PET during contemporaneous IIC patterns attributed to structural lesions (44 %), neuroinflammatory/neuroinfectious disease (39 %), or epilepsy (11 %). FDG-PET hypermetabolism was common (61 %) and predicted electrographic or electroclinical SE (sensitivity 79 % [95 % CI 53–93 %] and specificity 100 % [95 % CI 51–100 %]; p = 0.01). Excluding electrographic SE, hypermetabolism also predicted electroclinical SE (sensitivity 80 % [95 % CI 44–94 %] and specificity 100 % [95 % CI 51–100 %]; p = 0.01). Conclusions In hospitalized patients with IIC EEG patterns, FDG-PET hypermetabolism is common and is a candidate metabolic biomarker of electrographic SE or electroclinical SE.

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Section: Discussionsupporting

confidence: 70%

Metabolic Correlates of the Ictal-Interictal Continuum: FDG-PET During Continuous EEG

et al. 2016

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“…Clinical/EEG description (Stayman & Abou‐Khalil, 2011): A 51‐year‐old woman with evolution of bizarre behavior such as placing her cell phone in the microwave, placing a glass tumbler into the blender while attempting to make herself a cocktail, and perseverative behaviors such as repeating “channel 168” while manipulating the television remote. She had deficits in recall, attention, and judgment.…”

Section: Ncse Occurring In Both Childhood and Adulthoodmentioning

confidence: 99%

Electroencephalographic criteria for nonconvulsive status epilepticus: Synopsis and comprehensive survey

2012

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SUMMARYThere have been many attempts at defining the electroencephalography (EEG) characteristics of nonconvulsive status epilepticus (NCSE) without a universally accepted definition. This lack of consensus arises because the EEG expression of NCSE does not exist in isolation, but reflects status epilepticus under the variety of pathologic conditions that occur with age, cerebral development, encephalopathy, and epilepsy syndrome. Current NCSE definitions include ''boundary conditions,'' in which electroencephalographic seizure activity occurs without apparent clinical seizures. Furthermore, what appears to one interpreter as status epilepticus, is not to another reader, reflecting the ''art'' of EEG interpretation. Seizures and epilepsy syndromes have undergone an evolution that has moved beyond a classification of focal or generalized conditions into a syndromic approach. It seems appropriate to make similar changes in the EEG analysis of the syndromes of NCSE. In effect, the literature on epilepsy classification has progressed to incorporate the different NCSE types with clinical descriptions, but the specific EEG evidence for these types is found largely in individual reports, and often by description only. NCSE classification of EEG patterns should derive from the aggregate of published EEG patterns in the respective clinical subtype, supported by an analysis of these EEG studies. The analysis that follows presents clinical descriptions and EEG patterns of NCSE in the neonatal period, infancy, childhood, adulthood, and late adulthood from a syndromic perspective based on age, encephalopathy, cerebral development, etiology, and syndrome. Proceeding from the proposed classification of status epilepticus syndromes in ''Status epilepticus: its clinical features and treatment in children and adults'' (published in 1994 by Cambridge University Press, New York), we have performed a systematic search for reports presenting EEG patterns of NCSE using the online medical search engine PubMed for 22 different search strategies. EEG patterns were reviewed by two board-certified epileptologists who reached consensus regarding presence of NCSE. From a total of 4,328 search results, 123 cases with corresponding EEG patterns could be allocated to underlying epilepsy syndromes. Typical characteristic, prominent electrographic patterns, and sequential arrangements are elucidated for the different NCSE syndromes. This compendium of patterns by NCSE syndrome classification with illustration of EEGs, and delineation of electroencephalographic features helps define the characteristics and semiologic borderlines among the types of NCSE. KEY WORDS: Epilepsy, Nonconvulsive status epilepticus, Electroencephalographic criteria, Diagnosis criteria, Clinical syndromes, Electroencephalographic patterns, Neonatal, Infants, Childhood, Adults, Late life.Nonconvulsive status epilepticus (NCSE) has been defined as a state of ongoing (or nonrecovery between) seizures without convulsions, usually for more than 30 min (Shorvon, 1994;Kaplan, 1996...

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“…Estas descargas periódicas aparecen en encefalopatías toxicometabólicas o anoxoisquémicas, enfermedades neurodegenerativas o infecciones del sistema nervioso central, y pueden ser lateralizadas, lateralizadas bilaterales independientes, generalizadas, ondas trifásicas e inducidas por un estímulo [56]. Recientemente, se ha descrito la utilidad, asimismo, de la tomografía por emisión de positrones con fluorodeoxiglucosa en el diagnóstico de un EEPC [57].…”

Section: Diagnósticounclassified

Estado epiléptico no convulsivo en el siglo XXI: clínica, diagnóstico, tratamiento y pronóstico

Gómez‐Ibáñez¹,

Urrestarazu²,

Viteri³

2012

RevNeurol

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estado epiléptico no convulsivo es una patología importante para el neurólogo porque, a pesar de su baja prevalencia, puede confundirse con otras entidades, con las consiguientes implicaciones terapéuticas y pronósticas. El diagnóstico está basado en cambios clínicos, fundamentalmente del estado mental o nivel de conciencia habitual del paciente, y electroencefalográficos, por lo que el electroencefalograma es la herramienta básica que hemos de utilizar ante la sospecha clínica. Existen tres tipos: generalizado o estado de ausencia, con grafoelementos epileptiformes difusos en el trazado electroencefalográfico; focal, con descargas localizadas en una área cerebral concreta y que pueden no afectar a la conciencia; y sutil, con actividad epileptiforme focal o difusa asociada a poca o ninguna actividad motora tras una crisis tonicoclónica generalizada o un estado convulsivo. El tratamiento consta de benzodiacepinas y fármacos antiepilépticos; los anestésicos están indicados únicamente en el estado sutil y casos graves de estado parcial complejo. El pronóstico depende principalmente de la etiología y el daño cerebral asociado. Palabras clave. Benzodiacepinas. Conciencia. Electroencefalograma. Estado no convulsivo.

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FDG-PET in the diagnosis of complex partial status epilepticus originating from the frontal lobe

Cited by 18 publications

References 7 publications

Metabolic Correlates of the Ictal-Interictal Continuum: FDG-PET During Continuous EEG

Metabolic Correlates of the Ictal-Interictal Continuum: FDG-PET During Continuous EEG

Electroencephalographic criteria for nonconvulsive status epilepticus: Synopsis and comprehensive survey

Estado epiléptico no convulsivo en el siglo XXI: clínica, diagnóstico, tratamiento y pronóstico

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