Usefulness of pulsed arterial spin-labeling MRI for localizing a seizure focus: A surgical case

Sakai, Kenji; Kamida, Tohru; Matsuta, Hiroyuki; Shimomura, Tsuyoshi; Fujiki, Minoru

doi:10.1016/j.seizure.2014.01.005

Cited by 11 publications

(5 citation statements)

References 6 publications

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“…In one study of 16 patients (nine with temporal lobe epilepsy), the spatial resolution in ASL was slightly lower than in FDG‐PET, but ASL provided just as much information about the location of the EZ . Only isolated cases of neocortical epilepsy have been reported, including three patients with tuberous sclerosis , four patients with malformations of cortical development and two with post‐traumatic epilepsy . Overall, these studies correlated well with other tests .…”

Section: Discussionmentioning

confidence: 89%

“…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]. Our purpose was to assess the accuracy of ASL to locate the EZ in patients with DRNE by comparing ASL with the results generated by PET, subtraction ictal SPECT co-registered to MRI (SISCOM), structural MRI (sMRI), long-term video-EEG, and with the EZ determined by consensus after multidisciplinary non-invasive evaluations (including all the tests previously mentioned).…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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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“…ASL has also been used to detect interictal and postictal alterations in brain perfusion dynamics in focal epilepsy to localize the SOZ. Most of these studies are small case series and yielded inconsistent results, including focal and hemispheric hypoperfusion, hyperperfusion, or no significant perfusion changes (Wolf et al, 2001;Lim et al, 2008;Pizzini et al, 2008Pizzini et al, , 2013Altrichter et al, 2009;Nguyen et al, 2010;Pendse et al, 2010;Miyaji et al, 2014;Sugita et al, 2014). Some studies used asymmetries in CBF to lateralize the SOZ in temporal lobe epilepsy (Wolf et al, 2001;Lim et al, 2008;Eryurt et al, 2015;Guo et al, 2015;Oner et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Seizure onset zone localization using postictal hypoperfusion detected by arterial spin labelling MRI

Gaxiola‐Valdez

Singh

Perera

et al. 2017

Brain

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Neurological dysfunction following epileptic seizures is a well-recognized phenomenon. Several potential mechanisms have been suggested to explain postictal dysfunction, with alteration in cerebral blood flow being one possibility. These vascular disturbances may be long lasting and localized to brain areas involved in seizure generation and propagation, as supported by both animal and human studies. Therefore, measuring perfusion changes in the postictal period may help localize the seizure onset zone. Arterial spin labelling is a non-invasive, rapid and reproducible magnetic resonance imaging technique that measures cerebral perfusion. To this end, we measured postictal perfusion in patients with drug resistant focal epilepsy who were admitted to our seizure-monitoring unit for presurgical evaluation. Twenty-one patients were prospectively recruited and underwent arterial spin labelling scanning within 90 min of a habitual seizure. Patients also underwent a similar scan in the interictal period, after they were seizure-free for at least 24 h. The acquired scans were subtracted to identify the areas of significant postictal hypoperfusion. The location of the maximal hypoperfusion was compared to the presumed seizure onset zone to assess for concordance. Also, the localizing value of this technique was compared to other structural and functional imaging modalities. Postictal perfusion reductions of >15 units (ml/100 g/l) were seen in 15/21 patients (71.4%). In 12/15 (80%) of these patients, the location of the hypoperfusion was partially or fully concordant with the location of the presumed seizure onset zone. This technique compared favourably to other neuroimaging modalities, being similar or superior to structural magnetic resonance imaging in 52% of cases, ictal single-photon emission computed tomography in 60% of cases and interictal positron emission tomography in 71% of cases. Better arterial spin labelling results were obtained in patients in whom the seizure onset zone was discernible based on non-invasive data. Thus, this technique is a safe, non-invasive and relatively inexpensive tool to detect postictal hypoperfusion that may provide useful data to localize the seizure onset zone. This technique may be incorporated into the battery of conventional investigations for presurgical evaluation of patients with drug resistant focal epilepsy.

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“…One study reported that continuous EEG monitoring could detect over 14% of patients with NCSE after convulsive SE had been controlled (10). In cases that are difficult to diagnose with NCSE, functional imaging, such as arterial spin labeling (ASL) and SPECT, may help detect NCSE (11). The other possible pathogenesis of the hemispheric involvement was that the patient had encephalopathy, which resulted in refractory SE.…”

Section: Discussionmentioning

confidence: 99%

An Adult Case of Hemiplegia, Aphasia, and Hemispheric Atrophy Associated with Febrile Status Epilepticus

2021

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A 43-year-old man with a preceding infection was transferred to our hospital for febrile status epilepticus (SE). Although treatment for SE was immediately initiated, it failed. Therefore, continuous anesthetics treatment with mechanical ventilation was initiated. No epileptic discharge was found on an electroencephalogram. However, total aphasia and right hemiplegia due to left hemispheric swelling were noted on day 5. His aphasia and hemiplegia did not improve. The mechanism underlying the hemispheric involvement remains unclear. The initial diagnosis should be made with care in patients with febrile SE; furthermore, intensive treatment should be administered in the acute phase.

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Usefulness of pulsed arterial spin-labeling MRI for localizing a seizure focus: A surgical case

Cited by 11 publications

References 6 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

Seizure onset zone localization using postictal hypoperfusion detected by arterial spin labelling MRI

An Adult Case of Hemiplegia, Aphasia, and Hemispheric Atrophy Associated with Febrile Status Epilepticus

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