Similar brain spect findings in subclinical and clinical seizures in two neonates with hemimegalencephaly

Alfonso, Israel; Papazian, Óscar; Litt, Richard; Villalobos, Rafael; Acosta, Jose I

doi:10.1016/s0887-8994(98)00030-7

Cited by 16 publications

(4 citation statements)

References 3 publications

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“…The most classic SPECT pattern consists of an ictal CBF increase and an interictal CBF decrease in the dysplasia (37–39). Similar patterns were found whatever the child's age, involving neonates (6,40). Interictal CBF increase also has been reported in infants with cortical dysgenesis, suggesting a more active epileptogenicity at this age (10,41).…”

Section: Discussionsupporting

confidence: 71%

The Nonmalformed Hemisphere Is Secondarily Impaired in Young Children with Hemimegalencephaly: A Pre‐ and Postsurgery Study with SPECT and EEG

Soufflet¹,

Bulteau²,

Delalande³

et al. 2004

Epilepsia

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Summary:Purpose: To study separately the functional value of each cerebral hemisphere in hemimegalencephaly (HME). HME is a unique model of unilateral hemispheric lesion, but one suspects that the non-HME hemisphere also could be functionally impaired because the postsurgery outcome is less favorable than expected.Methods: We performed simultaneous prolonged EEG and 133-xenon SPECT (single-photon emission computed tomography); we measured the absolute values of cerebral blood flow (CBF) in both hemispheres and compared them with the normal values previously acquired. Thirteen patients (aged 5-38 months) underwent 31 examinations, 20 before surgery (hemispherotomy) and 11 after.Results: In the HME hemisphere, we confirmed the presurgical mixture of increased and decreased CBF due to intermittent ictal discharges. After surgery, CBF was decreased in most cases. In the non-HME hemisphere, presurgery CBF was abnormal in 60% of the patients, increased and related mostly to diffuse interictal spikes on the same side, whereas normal CBF cases had focal spikes. After surgery, CBF was normal in 82% of cases, corresponding to an EEG without diffuse spikes. In the six patients longitudinally studied, CBF dramatically decreased after surgery in the HME hemisphere, whereas in the non-HME hemisphere, CBF was mostly normal very early (three fourths before 2 months), increased as soon as 3 months, and normalized only after hemispherotomy, the more rapidly the child was operated on, the earlier it was.Conclusions: This study shows that the function of the nonmalformed hemisphere is impaired as soon as the first months of the course of HME but can be restored after surgery. Our data support the recommendations to operate on the children as early as possible.

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Section: Discussionsupporting

confidence: 71%

The Nonmalformed Hemisphere Is Secondarily Impaired in Young Children with Hemimegalencephaly: A Pre‐ and Postsurgery Study with SPECT and EEG

Soufflet¹,

Bulteau²,

Delalande³

et al. 2004

Epilepsia

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“…Interestingly in one case, seizures involving the right temporal lobe were also associated with increased activity in limbic projection sites (hippocampus and cingulate cortex). Chugani et al (1994) distinguished between three dominant ictal rCMRGlc patterns in 18 children including "hypermetabolism restricted to cerebral cortex" and taken together with such observations, the BOLD activation patterns presented are extremely plausible both anatomically and neurobiologically as well as being in keeping with the patients clinical picture and provide further support for similar activation patterns arising from subclinical and clinical seizure activity (Handforth et al, 1994;Alfonso et al, 1998).…”

Section: Fig 3 (A)mentioning

confidence: 69%

Simultaneous EEG-Correlated Ictal fMRI

et al. 2002

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“…This suggests an alteration (in number or structure) of underlying macrovessels and microvessels. In previous studies about perfusion in hemimegalencephaly performed with PET and SPECT, most authors found hypermetabolism and hypervascularization in the megalencephalic hemisphere, and related it to the epileptical activity, because their patients already presented with clinical seizures when the examinations were performed [1,8,9,11] . Our patient was seizure-free, when the early radiological imaging was performed at 5 days of life.…”

Section: Discussionmentioning

confidence: 99%

“…There are 3 types of hemimegalencephaly [4] . (1) The isolated form occurs as a sporadic disorder without hemicorporal hypertrophy, cutaneous or systemic involvement. (2) The syndromic form is associated with other diseases.…”

Section: Introductionmentioning

confidence: 99%