Inter-hemispheric asymmetry of cerebral flow velocities during generalized spike-wave discharges

Simone, Roberto De; Placidi, Fabio; Diomedi, Marina; Marciani, Maria Grazia; Silvestrini, Mauro

doi:10.1007/s00415-002-0803-4

Cited by 9 publications

(11 citation statements)

References 8 publications

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“…The interhemispheric asymmetry was significant and in favor of the left side in our patients. Significant asymmetry in the CBFV increase was previously reported only by De Simone et al [6] in absence seizures and in electrically induced seizures [18]. Asymmetric increase in cerebral blood flow was also observed in partial seizures as expected [9,13].…”

Section: Discussionsupporting

confidence: 58%

“…The ictal increase in CBFV has been reported in absence seizures [5,6], gSWDs [7], electrically induced seizures [17,18], and partial seizures [9,13,19]. However, contradictory results were also reported, indicating a decrease in CBFV in absence seizures [2,11,16] and in gSWDs [8].…”

Section: Discussionmentioning

confidence: 99%

“…A few TCD studies dealing with cerebral hemodynamics in CAE [2,5,6,11,16], gSWDs without seizures [7,8], partial epilepsy [13,19], or electrically induced generalized seizures [17,18] are available in the literature. It is assumed that CBFV monitoring with TCD was a more sensitive system in evaluating abrupt cerebral blood flow changes during seizures despite the poor spatial resolution, according to previous experience.…”

Section: Discussionmentioning

confidence: 99%

“…An ictal increase in CBFV has been reported [5,6]. However, contradictory results were also reported indicating a decrease in CBFV in absence seizures [2,11,16].…”

Section: Introductionmentioning

confidence: 97%

“…A few TCD studies, having dealt with ictal cerebral hemodynamics in childhood absence epilepsy (CAE) and juvenile absence epilepsy (JAE), are available in the literature [2,5,6,11,16]. An ictal increase in CBFV has been reported [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Lateralization of cerebral blood flow in juvenile absence seizures

Bek¹,

Kaşikçi²,

Genç³

et al. 2010

J Neurol

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Cerebrovascular blood flow in absence seizures and flow patterns during the ictal period have not been thoroughly investigated. We aimed to evaluate cerebral blood flow changes in typical juvenile absence seizures during the ictal and postictal phases. Seizures were recorded in three patients (mean age: 21 +/- 1 years) with multiple daily typical absence seizures. Simultaneous video electroencephalography and bilateral middle cerebral artery transcranial Doppler ultrasonography recordings were conducted during seizures. Basal, ictal, and postictal blood flow velocities were recorded bilaterally, and offline analyses were performed in relation with generalized spike and wave discharges. Total of 43 seizures were recorded. Ictal increase and postictal decrease of cerebral blood flow velocities were significant for both sides (P < 0.001). The interhemispheric asymmetry in the ictal velocity increase was significant (P < 0.05). The interhemispheric asymmetry in the postictal velocity decrease was not significant (P > 0.05). The blood flow velocity increase after seizure onset indicates a vascular coupling mechanism. A sudden and then a gradual decrease in blood flow velocity, which lasted even after the seizure ceased, might suggest a preventive mechanism to avoid excessive seizure duration or even an absence status epilepticus. Significant asymmetries in increase and a symmetrical decrease may support the cortical focus theory.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…An ictal increase in CBFV has been reported [5,6]. However, contradictory results were also reported indicating a decrease in CBFV in absence seizures [2,11,16].…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lateralization of cerebral blood flow in juvenile absence seizures

Bek¹,

Kaşikçi²,

Genç³

et al. 2010

J Neurol

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Non-Convulsive Status Epilepticus (NCSE) in ICU: Bedside Usefulness of TCD in Comatose Patient Diagnosis. When the EEG Is Too Far

Othman

Abd‐Allah

2021

Neurosonology in Critical Care

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Points 1. Nonconvulsive status epilepticus (NCSE) is an important cause for unexplained impairment of consciousness, particularly in the intensive care unit (ICU). 2. Generation of abnormally prolonged or repeatedly recurrent brain electrical activity represents a metabolic burden not only on the neurons but also on the glial cells. This should be coupled by increase in cerebral blood flow (CBF). 3. The merits of the TCCS (transcranial color-coded duplex sonography) are being available, fast, bedside, safe, repeatable, and not interfering with continuous monitoring in the ICU. 4. TCCS assessment can help not only in diagnosis and follow-up of NCSE/IIC, but also in identifying the underlying etiology: arterial stenosis as a cause of acute ischemic stroke (AIS), dural venous sinus thrombosis, hydrocephalus, increased of ICP (by MLS, ONSD, and papilledema measurements) as in cases caused of space-occupying lesions (SOLs) (neoplasms, intra-and extra-axial hematoma, etc.). 5. Indirect assessment of cerebral blood flow (CBF) through cerebral blood flow velocities (CBFVs) measurement using TCD/TCCS was the most studied application of neurosonology in epileptic seizures, due to its ability to provide realtime evaluation at bedside. 6. EEG is the gold standard for diagnosis of NCSE/IIC; however, it can be unavailable or not conclusive enough. In these cases, vascular imaging can help to establish the diagnosis.

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