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Alves VDPV, Care MM, Leach JL. Incidental Thalamic Lesions Identified on Brain MRI in Pediatric and Young Adult Patients: Imaging Features and Natural History. AJNR Am J Neuroradiol 2024; 45:211-217. [PMID: 38238093 DOI: 10.3174/ajnr.a8090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/06/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND PURPOSE Nonspecific, localized thalamic signal abnormalities of uncertain significance are occasionally found on pediatric brain MR imaging. The goal of this study is to describe the MR imaging appearance and natural history of these lesions in children and young adults. MATERIALS AND METHODS This retrospective study evaluated clinically acquired brain MR imaging examinations obtained from February 1995 to March 2022 at a large, tertiary care pediatric hospital. Examinations with non-mass-like and nonenhancing thalamic lesions were identified based on term search of MR imaging reports. A total of 221 patients formed the initial group for imaging assessment. Additional exclusions during imaging review resulted in 171 patients. Imaging appearance and size changes were assessed at baseline and at follow-up examinations. RESULTS A total of 171 patients (102 male) at a median age of 11 years (range: 1-23 years), 568 MR imaging examinations, and 180 thalamic lesions were included. Median time from baseline to the last follow-up MR imaging was 542 days (range: 46-5730 days). No lesion enhanced at any time point. On imaging follow-up, 11% of lesions (18/161) became smaller, 10% (16/161) resolved, 73% (118/161) remained stable, and 6% (9/161) increased in size at some point during evaluation. Median time interval from baseline to enlargement was 430 days (range: 136-1074 days). CONCLUSIONS Most incidental, non-mass-like thalamic signal abnormalities were stable, decreased in size, or resolved on follow-up imaging and are likely of no clinical significance. Surveillance strategies with longer follow-up intervals may be adequate in the management of such findings.
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Affiliation(s)
- Vinicius de Padua V Alves
- From the Department of Radiology (V.d.P.V.A., M.M.C., J.L.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Marguerite M Care
- From the Department of Radiology (V.d.P.V.A., M.M.C., J.L.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Radiology (M.M.C., J.L.L.), University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - James L Leach
- From the Department of Radiology (V.d.P.V.A., M.M.C., J.L.L.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Radiology (M.M.C., J.L.L.), University of Cincinnati College of Medicine, Cincinnati, Ohio
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2
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Fisher RS. Deep brain stimulation of thalamus for epilepsy. Neurobiol Dis 2023; 179:106045. [PMID: 36809846 DOI: 10.1016/j.nbd.2023.106045] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Neuromodulation (neurostimulation) is a relatively new and rapidly growing treatment for refractory epilepsy. Three varieties are approved in the US: vagus nerve stimulation (VNS), deep brain stimulation (DBS) and responsive neurostimulation (RNS). This article reviews thalamic DBS for epilepsy. Among many thalamic sub-nuclei, DBS for epilepsy has been targeted to the anterior nucleus (ANT), centromedian nucleus (CM), dorsomedial nucleus (DM) and pulvinar (PULV). Only ANT is FDA-approved, based upon a controlled clinical trial. Bilateral stimulation of ANT reduced seizures by 40.5% at three months in the controlled phase (p = .038) and 75% by 5 years in the uncontrolled phase. Side effects related to paresthesias, acute hemorrhage, infection, occasional increased seizures, and usually transient effects on mood and memory. Efficacy was best documented for focal onset seizures in temporal or frontal lobe. CM stimulation may be useful for generalized or multifocal seizures and PULV for posterior limbic seizures. Mechanisms of DBS for epilepsy are largely unknown, but animal work points to changes in receptors, channels, neurotransmitters, synapses, network connectivity and neurogenesis. Personalization of therapies, in terms of connectivity of the seizure onset zone to the thalamic sub- nucleus and individual characteristics of the seizures, might lead to improved efficacy. Many questions remain about DBS, including the best candidates for different types of neuromodulation, the best targets, the best stimulation parameters, how to minimize side effects and how to deliver current noninvasively. Despite the questions, neuromodulation provides useful new opportunities to treat people with refractory seizures not responding to medicines and not amenable to resective surgery.
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Affiliation(s)
- Robert S Fisher
- Department of Neurology and Neurological Sciences and Neurosurgery by Courtesy, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 213 Quarry Road, Room 4865, Palo Alto, CA 94304, USA.
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3
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Carvalho D, Mendonça C, Carvalho J, Martins A, Leal A. High incidence of early thalamic lesions in the Continuous Spike-Wave related with slow Sleep (CSWS). Epilepsy Behav 2023; 138:109031. [PMID: 36512931 DOI: 10.1016/j.yebeh.2022.109031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Continuous Spike-Wave during slow Sleep (CSWS) syndrome associates a clinically important neurocognitive regression with strong activation of non-REM sleep spikes. Its mechanisms remain unknown, but a contribution of rare perinatal thalamic injuries has been highlighted. We determine the incidence of such lesions in a cohort of CSWS patients. METHODS N = 65 patients with CSWS and a control group (N = 51) were studied. Spikes were quantified in long-term ambulatory EEGs, brain Magnetic Ressonance Imaging (MRI) structural lesions were assessed and thalamic volumetry was performed. A neurocognitive scale was used to assess dysfunction. RESULTS The most common etiologies in the control patients were not represented in the CSWS group. Structural lesions were detected in a minority of CSWS patients (25/53) but included a thalamic injury in the large majority (24/25). This ratio was 4/40 in controls. Lesions belonged to one of five types: 1. Circumscribed to the thalamus (N = 11); 2. Extending beyond the thalamus (N = 3); 3. Hypothalamic-Hamartomas (N = 4); 4. Periventricular-Leukomalacia (N = 4); 5. Hypoplasia-Polymicrogyria (N = 1). Most lesions were lateralized to one hemisphere, which in all cases corresponded to the lateralization of the CSWS. SIGNIFICANCE Thalamic lesions are present in most CSWS patients with abnormal MRIs, supporting an important role in its genesis.
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Affiliation(s)
- Daniel Carvalho
- Laboratório de EEG, Serviço Neuropediatria, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal.
| | - Carla Mendonça
- Centro Desenvolvimento Pediátrico, Departamento Pediatria, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
| | - João Carvalho
- Pediatric Neurology, Centro de Desenvolvimento Torrado da Silva, Hospital Garcia de Orta, Almada, Portugal.
| | - Ana Martins
- Pediatric Neurology, Hospital da Luz, Lisbon, Portugal.
| | - Alberto Leal
- Unidade Autónoma de Neurofisiologia, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal.
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4
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Meys KME, de Vries LS, Groenendaal F, Vann SD, Lequin MH. The Mammillary Bodies: A Review of Causes of Injury in Infants and Children. AJNR Am J Neuroradiol 2022; 43:802-812. [PMID: 35487586 PMCID: PMC9172959 DOI: 10.3174/ajnr.a7463] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/22/2021] [Indexed: 12/20/2022]
Abstract
Despite their small size, the mammillary bodies play an important role in supporting recollective memory. However, they have typically been overlooked when assessing neurologic conditions that present with memory impairment. While there is increasing evidence of mammillary body involvement in a wide range of neurologic disorders in adults, very little attention has been given to infants and children. Literature searches of PubMed and EMBASE were performed to identify articles that describe mammillary body pathology on brain MR imaging in children. Mammillary body pathology is present in the pediatric population in several conditions, indicated by signal change and/or atrophy on MR imaging. The main causes of mammillary body pathology are thiamine deficiency, hypoxia-ischemia, direct damage due to masses or hydrocephalus, or deafferentation resulting from pathology within the wider Papez circuit. Optimizing scanning protocols and assessing mammillary body status as a standard procedure are critical, given their role in memory processes.
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Affiliation(s)
- K M E Meys
- From the Department of Radiology (K.M.E.M., F.G., M.H.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - L S de Vries
- Department of Neonatology (L.S.D.V.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - F Groenendaal
- From the Department of Radiology (K.M.E.M., F.G., M.H.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - S D Vann
- School of Psychology (S.D.V.), Cardiff University, Cardiff, UK
| | - M H Lequin
- From the Department of Radiology (K.M.E.M., F.G., M.H.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
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5
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Lee DA, Lee J, Kim HC, Park KM, Kim SE. Hippocampal injury in patients with status epilepticus: Quantitative analysis of hippocampal volume and structural co-variance network. Seizure 2022; 95:84-89. [PMID: 35030375 DOI: 10.1016/j.seizure.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the differences in hippocampal structural volumes and intra-hippocampal networks between patients with status epilepticus (SE) and healthy controls. METHODS We enrolled 45 patients with SE and 35 age- and sex-matched healthy controls. We excluded patients with active structural lesions, which could be a direct cause of SE, but included patients with co-existing lesions. Co-existing lesions were defined as any lesions possibly related to the occurrence of SE, including encephalomalacia, cavernous malformation, dural arteriovenous fistula, and normal pressure hydrocephalus, etc. We divided 45 patients into those with co-existing lesions (n = 21) and those without co-existing lesions (n = 24). We conducted a volumetric analysis using FreeSurfer (version 7), and the intra-hippocampal structural co-variance network was analyzed with a graph theoretical analysis based on the structural volumes of the hippocampal subfields. RESULTS The structural volumes and intra-hippocampal structural co-variance networks were not different between patients with and without co-existing lesions. However, both structural volumes and intra-hippocampal structural co-variance networks were significantly different in patients with SE compared to healthy controls, and the ratio of the volume difference: [(volume of controls-volume of patients)/volume of controls] was highest in the left hippocampus (0.195), left amygdala (0.143), left thalamus (0.126), and right cortex (0.084). In addition, the global connectivity measurements including radius, diameter, eccentricity, and assortativity were significantly increased, and the small-worldness index was significantly decreased in patients with SE. Notably, structural volumes were negatively related to age but not to the duration of SE. SIGNIFICANCE Our study revealed significant alterations in structural volumes and intra-hippocampal structural co-variance networks in patients with SE compared to healthy controls, even though hippocampal atrophy was not evident on visual analysis; this is likely due to the direct effect of SE itself.
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Affiliation(s)
- Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Joonwon Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hyung Chan Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
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6
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Mariajoseph FP, Muthusamy S, Amukotuwa S, Seneviratne U. Seizure-induced reversible MRI abnormalities in patients with single seizures: a systematic review. Epileptic Disord 2021; 23:552-562. [PMID: 34240708 DOI: 10.1684/epd.2021.1300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/24/2021] [Indexed: 11/17/2022]
Abstract
Differentiating seizure-induced reversible MRI abnormalities from MRI changes secondary to underlying cerebral pathologies can be challenging for clinicians in the investigation of seizures. The aim of this study was to delineate the characteristic features of reversible seizure-induced MRI abnormalities. A systematic search of the databases Medline (1946-2020), PubMed (1996-2020), and Embase (1947-2020) was performed in keeping with the Preferred Items Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All publications in English, including case reports, of single unprovoked seizure patients with seizure-induced MRI abnormalities demonstrating complete resolution, were included. Two authors extracted data using a predefined template and evaluated the quality of the included studies. MRI data were additionally reviewed by a neuroradiologist. All data were synthesised qualitatively. There were 11 publications altogether, yielding a total of 27 cases that were pertinent to our research question. Abnormalities were most commonly observed on T2-weighted sequences. The most commonly observed constellations of MRI features ("composite pattern") included the following: cortical or subcortical signal change with or without leptomeningeal enhancement, signal abnormality in the splenium of the corpus callosum, and hippocampal signal abnormality. Seizure-induced reversible MRI abnormalities were observed as early as six hours from seizure onset and resolved completely as early as five days from seizure onset. A key limitation of this systematic review was the variability and incomplete reporting of clinical data, especially with regards to seizure semiology and MRI sequences performed, which may have limited our ability to make more definitive conclusions. Seizure-induced reversible MRI changes may appear within hours of seizure onset and resolve within a variable time frame, ranging from days to weeks. Bilateral seizure-induced reversible MRI abnormalities tend to be associated with generalised seizures while unilateral seizure-induced reversible MRI abnormalities may be associated with focal seizures, usually ipsilateral to the seizure focus.
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Affiliation(s)
- Frederick P Mariajoseph
- School of Clinical Sciences at Monash Health, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | - Udaya Seneviratne
- School of Clinical Sciences at Monash Health, Department of Medicine, Monash University, Melbourne, Victoria, Australia, Department of Neurology, Monash Medical Centre, Clayton, Melbourne, Australia, Department of Medicine, St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
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7
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Characterization of the Expression of the ATP-Gated P2X7 Receptor Following Status Epilepticus and during Epilepsy Using a P2X7-EGFP Reporter Mouse. Neurosci Bull 2020; 36:1242-1258. [PMID: 32895896 DOI: 10.1007/s12264-020-00573-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/08/2020] [Indexed: 12/18/2022] Open
Abstract
Mounting evidence suggests that the ATP-gated P2X7 receptor contributes to increased hyperexcitability in the brain. While increased expression of P2X7 in the hippocampus and cortex following status epilepticus and during epilepsy has been repeatedly demonstrated, the cell type-specific expression of P2X7 and its expression in extra-hippocampal brain structures remains incompletely explored. In this study, P2X7 expression was visualized by using a transgenic mouse model overexpressing P2X7 fused to the fluorescent protein EGFP. The results showed increased P2X7-EGFP expression after status epilepticus induced by intra-amygdala kainic acid and during epilepsy in different brain regions including the hippocampus, cortex, striatum, thalamus and cerebellum, and this was most evident in microglia and oligodendrocytes. Co-localization of P2X7-EGFP with cell type-specific markers was not detected in neurons or astrocytes. These data suggest that P2X7 activation is a common pathological hallmark across different brain structures, possibly contributing to brain inflammation and neurodegeneration following acute seizures and during epilepsy.
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8
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Hanin A, Lambrecq V, Denis JA, Imbert-Bismut F, Rucheton B, Lamari F, Bonnefont-Rousselot D, Demeret S, Navarro V. Cerebrospinal fluid and blood biomarkers of status epilepticus. Epilepsia 2019; 61:6-18. [PMID: 31828792 DOI: 10.1111/epi.16405] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 12/28/2022]
Abstract
Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms that lead to abnormally prolonged seizures and require urgent administration of antiepileptic drugs. Refractory status epilepticus requires anesthetics drugs and may lead to brain injury with molecular and cellular alterations (eg, inflammation, and neuronal and astroglial injury) that could induce neurologic sequels and further development of epilepsy. Outcome scores based on demographic, clinical, and electroencephalography (EEG) condition are available, allowing prediction of the risk of mortality, but the severity of brain injury in survivors is poorly evaluated. New biomarkers are needed to predict with higher accuracy the outcome of patients admitted with status in an intensive care unit. Here, we summarize the findings of studies from patients and animal models of status epilepticus. Specific protein markers can be detected in the cerebrospinal fluid and the blood. One of the first described markers of neuronal death is the neuron-specific enolase. Gliosis resulting from inflammatory responses after status can be detected through the increase of S100-beta, or some cytokines, like the High Mobility Group Box 1. Other proteins, like progranulin may reflect the neuroprotective mechanisms resulting from the brain adaptation to excitotoxicity. These new biomarkers aim to prospectively identify the severity and development of disability, and subsequent epilepsy of patients with status. We discuss the advantages and disadvantages of each biomarker, by evaluating their brain specificity, stability in the fluids, and sensitivity to external interferences, such as hemolysis. Finally, we emphasize the need for further development and validation of such biomarkers in order to better assess patients with severe status epilepticus.
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Affiliation(s)
- Aurélie Hanin
- Brain and Spine Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Virginie Lambrecq
- Brain and Spine Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France.,Epilepsy Unit (VL, VN) and Neuro-Intensive care Unit (SD), Neurology Department, AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France.,Sorbonne Université, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, Paris, France.,Department of Endocrine and Oncological Biochemistry (J.AD), Metabolic Biochemistry (BR, DBR, FI, FL), AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Françoise Imbert-Bismut
- Department of Endocrine and Oncological Biochemistry (J.AD), Metabolic Biochemistry (BR, DBR, FI, FL), AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Benoît Rucheton
- Department of Endocrine and Oncological Biochemistry (J.AD), Metabolic Biochemistry (BR, DBR, FI, FL), AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Foudil Lamari
- Department of Endocrine and Oncological Biochemistry (J.AD), Metabolic Biochemistry (BR, DBR, FI, FL), AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Dominique Bonnefont-Rousselot
- Department of Endocrine and Oncological Biochemistry (J.AD), Metabolic Biochemistry (BR, DBR, FI, FL), AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France.,UTCBS, U 1022 Inserm, UMR 8258 CNRS, Paris University, Paris, France
| | - Sophie Demeret
- Epilepsy Unit (VL, VN) and Neuro-Intensive care Unit (SD), Neurology Department, AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Vincent Navarro
- Brain and Spine Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France.,Epilepsy Unit (VL, VN) and Neuro-Intensive care Unit (SD), Neurology Department, AP-HP, GH Pitié-Salpêtrière-Charles Foix, Paris, France.,Sorbonne Université, Paris, France
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9
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Schertz M, Benzakoun J, Pyatigorskaya N, Belkacem S, Sahli-Amor M, Navarro V, Cholet C, Leclercq D, Dormont D, Law-Ye B. Specificities of arterial spin labeling (ASL) abnormalities in acute seizure. J Neuroradiol 2018; 47:20-26. [PMID: 30500358 DOI: 10.1016/j.neurad.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/10/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE Arterial spin labeling (ASL) is a non-invasive tool measuring cerebral blood flow (CBF) and is useful to assess acute neurological deficit. While acute stroke presents as hypoperfused vascular territory, epileptic activity causes cortical hyperperfusion. Other neurological conditions exhibit hyperperfusion, like migraine or secondary "luxury perfusion" in strokes. Our objectives were to evaluate the usefulness and potential specificities of ASL in acute seizure and correlate it with electroencephalogram. MATERIALS AND METHODS Amongst a cohort of patients with neurological deficit, addressed for suspicion of stroke, we retrospectively reviewed 25 consecutive patients with seizures who underwent magnetic resonance imaging (MRI) with ASL and electroencephalography (EEG). We compared them with a control group of patients with migraine and stroke secondary re-perfusion, exhibiting ASL hyperperfusion. RESULTS Lateralized cortical hyperperfusion (high relative CBF) was observed in all patients. Good topographic correlation with EEG was found in 18 patients (72%). Eight (32%) had hyperperfusion of ipsilateral pulvinar, 5 (20%) had hyperperfused contralateral cerebellar hemisphere, 16 (64%) presented diffusion abnormalities and 20 (80%) had underlying epileptogenic lesions. Pulvinar hyperperfusion was not observed in the control group, nor were diffusion abnormalities in migrainous patients. Contralateral cerebellar hyperperfusion was observed in two migrainous patient, without associated pulvinar activation, whereas all patients with cerebellar hyperperfusion in the study group had associated pulvinar activation. CONCLUSIONS Elevated CBF can be observed in the epileptogenic zone, ipsilateral pulvinar and contralateral cerebellum (diaschisis) in seizure. These abnormalities seem specific when compared with other causes of hyperperfusion. Arterial spin labeling can be highly effective in the differential diagnosis of strokes.
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Affiliation(s)
- Mathieu Schertz
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Joseph Benzakoun
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Nadya Pyatigorskaya
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France; Sorbonne universités, Pierre and Marie-Curie faculty of medicine, 75013 Paris, France
| | - Samia Belkacem
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Melika Sahli-Amor
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Vincent Navarro
- AP-HP, groupe hospitalier Pitié-Salpêtrière, epileptology department, 75013 Paris, France
| | - Clément Cholet
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Delphine Leclercq
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France
| | - Didier Dormont
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France; Sorbonne universités, Pierre and Marie-Curie faculty of medicine, 75013 Paris, France
| | - Bruno Law-Ye
- AP-HP, groupe hospitalier Pitié-Salpêtrière, neuroradiology department, 75013 Paris, France.
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10
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Fadda L, Floris G, Polizzi L, Meleddu L, Ercoli T, Garofalo P, Saba L, Muroni A, Defazio G. Pulvinar sign in a case of anti-CV2 encephalitis. J Neurol Sci 2018; 393:69-71. [PMID: 30121006 DOI: 10.1016/j.jns.2018.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Fadda
- Department of Medical Sciences and Public Health, University of Cagliari, Italy.
| | - Gianluca Floris
- Department of Neurology, University Hospital of Cagliari, Italy
| | - Lorenzo Polizzi
- Department of Neurology, University Hospital of Cagliari, Italy
| | - Lia Meleddu
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | | | - Luca Saba
- Department of Radiology, University of Cagliari, Italy
| | | | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
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11
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Meletti S, Monti G, Mirandola L, Vaudano AE, Giovannini G. Neuroimaging of status epilepticus. Epilepsia 2018; 59 Suppl 2:113-119. [PMID: 30160066 DOI: 10.1111/epi.14499] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 12/28/2022]
Abstract
In the past 2 decades we have observed an extensive use of different neuroimaging techniques to evaluate patients with status epilepticus. Magnetic resonance imaging (MRI) in particular may show a broad spectrum of abnormalities that are either the causes or the consequences of sustained epileptic activity. Neuroimaging techniques can offer a contribution both in the clinical management of individual patients, identifying hemodynamic patterns that support the diagnosis, and also in the recognition of periictal reversible or irreversible alterations. For the future it is necessary to develop larger and prospective studies in which imaging techniques and electroencephalography (EEG) recordings are acquired closely to understand which EEG patterns are related to imaging biomarkers of neuronal damage.
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Affiliation(s)
- Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Neurosciences, OCSAE Hospital, AOU Modena, Modena, Italy
| | - Giulia Monti
- Department of Neurosciences, OCSAE Hospital, AOU Modena, Modena, Italy
| | - Laura Mirandola
- Department of Biomedical, Metabolic and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Neurosciences, OCSAE Hospital, AOU Modena, Modena, Italy
| | - Anna Elisabetta Vaudano
- Department of Neurosciences, OCSAE Hospital, AOU Modena, Modena, Italy.,Department of Medicine and Surgery, Sleep Medicine Center, University of Parma, Parma, Italy
| | - Giada Giovannini
- Department of Neurosciences, OCSAE Hospital, AOU Modena, Modena, Italy
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Tsoures E, Lewerenz J, Pinkhardt E, Ludolph AC, Fauser S. Electroencephalographic findings in patients with circumscribed thalamic lesions. Epilepsy Res 2017; 135:115-122. [DOI: 10.1016/j.eplepsyres.2017.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 04/20/2017] [Accepted: 06/13/2017] [Indexed: 10/19/2022]
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Saniya K, Patil BG, Chavan MD, Prakash KG, Sailesh KS, Archana R, Johny M. Neuroanatomical Changes in Brain Structures Related to Cognition in Epilepsy: An Update. J Nat Sci Biol Med 2017; 8:139-143. [PMID: 28781476 PMCID: PMC5523517 DOI: 10.4103/0976-9668.210016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Understanding the microanatomical changes in brain structures is necessary for developing innovative therapeutic approaches to prevent/delay the cognitive impairment in epilepsy. We review here the microanatomical changes in the brain structures related to cognition in epilepsy. Here, we have presented the changes in major brain structures related to cognition, which helps the clinicians understand epilepsy more clearly and also helps researchers develop new treatment procedures.
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Affiliation(s)
- K Saniya
- Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam, Kerala, India
| | - B G Patil
- Department of Anatomy, Shri B. M. Patil Medical College, Bijapur, Karnataka, India
| | - Madhavrao D Chavan
- Department of Pharmacology, Azeezia Institute of Medical Sciences, Kollam, Kerala, India
| | - K G Prakash
- Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam, Kerala, India
| | - Kumar Sai Sailesh
- Department of Physiology, Little Flower Institute of Medical Sciences and Research, Angamaly, Kerala, India
| | - R Archana
- Department of Anatomy, Saveetha Medical College, Saveetha University, Chennai, Tamil Nadu, India
| | - Minu Johny
- Department of Physiology, Little Flower Institute of Medical Sciences and Research, Angamaly, Kerala, India
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Park KM, Kim SE, Shin KJ, Ha SY, Park J, Kim TH, Mun CW, Lee BI, Kim SE. Effective connectivity in temporal lobe epilepsy with hippocampal sclerosis. Acta Neurol Scand 2017; 135:670-676. [PMID: 27558524 DOI: 10.1111/ane.12669] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We hypothesized that temporal lobe epilepsy (TLE) patients with and without hippocampal sclerosis (HS) showed differences in their limbic networks. This study aimed to evaluate the role of the thalamus in TLE patients with HS. MATERIALS AND METHODS Twenty-nine TLE patients with HS and 30 controls were enrolled in this study. In addition, we included eight TLE patients without HS as a disease control group. Using whole-brain T1-weighted MRIs, we analyzed the volumes of the limbic structures, including the hippocampus, thalamus, and total cortex, with FreeSurfer 5.1. We also investigated the effective connectivity among these structures using SPSS Amos 21 based on these volumetric measures. Moreover, we quantified correlations between epilepsy duration and the volumes of these structures. RESULTS There was a statistically significant effective connectivity from the hippocampus to the thalamus in TLE patients with HS. Moreover, the volumes of the left and right thalamus were negatively correlated with epilepsy duration (r=-.42, P=.0315 and r=-.52, P=.0062, respectively). However, neither TLE patients without HS nor normal controls had a significant effective connectivity from the hippocampus to the thalamus. CONCLUSIONS The limbic networks of TLE patients with and without HS could be different, and the thalamus might play a critical role in TLE patients with HS.
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Affiliation(s)
- K. M. Park
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - S. E. Kim
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - K. J. Shin
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - S. Y. Ha
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - J. Park
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - T. H. Kim
- Department of Health Science and Technology; Inje University; Gimhae Korea
| | - C. W. Mun
- Department of Health Science and Technology; Inje University; Gimhae Korea
- Department of Biomedical Engineering/u-HARC; Inje University; Gimhae Korea
| | - B. I. Lee
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
| | - S. E. Kim
- Department of Neurology; Haeundae Paik Hospital; Inje University College of Medicine; Busan Korea
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Williams JA, Bede P, Doherty CP. An exploration of the spectrum of peri-ictal MRI change; a comprehensive literature review. Seizure 2017; 50:19-32. [PMID: 28600921 DOI: 10.1016/j.seizure.2017.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this review was to identify published studies in the literature relating to ictal induced MRI change and to identify certain common themes, practical points for clinicians and areas for future research. METHODS We identified 96 articles that satisfied our inclusion criteria yielding 575 cases. All articles were analysed; number of subjects, spectrum of MRI and EEG change, aetiology, and follow-up (both clinical and imaging) were noted. RESULTS The most frequent imaging changes were restricted diffusion, T2-hyperintensity and reduced ADC values. The mesial temporal structures and neocortex were most commonly affected locations though subcortical structures like the thalamus and pulvinar were also described. Practical clinical points included; the development of PLEDS concordant with ictal imaging change was associated with worse clinical prognosis, patients with seizures due to symptomatic aetiology may be more likely to develop ictal related imaging change and follow up is vitally important to ensure that ictal related oedema is not misidentified as a mass lesion or conversely that a mass lesion is not misidentified as ictal related change. CONCLUSION Qualitative MRI studies have provided clinicians with useful in-vivo insights into the dynamic ictal neuronal environment. Changes are not only localised to the ictal focus but can be remote and irreversible. Small patient numbers varying study design and high numbers of symptomatic seizures makes comparison between studies problematic. Also there is possible microstructural quantitative MRI changes that are missed on qualitative MRI. There is a need for prospective quantitative MRI studies in patients with epilepsy peri-icatlly with a uniform period of follow up and comparison to control data.
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Affiliation(s)
- Jennifer A Williams
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland.
| | - Peter Bede
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland
| | - Colin P Doherty
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland
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Pal S, Sen K, Biswas NM, Ghosal A, Rousan Jaman SK, Yashavantha Kumar KY. Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital. J Neurosci Rural Pract 2016; 7:114-24. [PMID: 26933357 PMCID: PMC4750307 DOI: 10.4103/0976-3147.165410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. MATERIALS AND METHODS All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. RESULTS Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. CONCLUSION This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome.
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Affiliation(s)
- Souren Pal
- Department of General Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Kaushik Sen
- Department of General Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Nirendra Mohan Biswas
- Department of General Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Anirban Ghosal
- Department of Neurology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - S K Rousan Jaman
- Department of General Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - K Y Yashavantha Kumar
- Department of General Medicine, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
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Grillo E. Postictal MRI abnormalities and seizure-induced brain injury: notions to be challenged. Epilepsy Behav 2015; 44:195-9. [PMID: 25745975 DOI: 10.1016/j.yebeh.2015.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This was a bibliographic search to address the quality of evidence in clinical reports supporting the assertion that brain MRI signal abnormalities are a direct consequence of seizures. METHODS The search on PubMed was performed by applying the following inclusion criteria: a) original case reports, b) in humans, c) as single case reports or series of patients, d) of visually detected acute MRI signal abnormalities, e) attributable directly to seizures, and f) published in English. Bibliographic references of initially selected publications were reviewed for additional articles. Full texts of selected publications were read for information regarding clinical, EEG, and MRI features. Moreover, claimed evidence supporting seizure-induced excitotoxicity was assessed. RESULTS The search resulted in 91 publications corresponding to 413 cases. There was a wide range of clinical features and EEG and MRI abnormalities. Premorbid or comorbid conditions were present in many cases, and some of them are potential causes of MRI changes. Claimed evidence for MRI signal abnormalities as a direct consequence of ictal activity was mostly based on the similarity with previous reports, animal models, reversibility, congruent EEG, MRI changes not respecting vascular territories, and ruling out other etiologies. CONCLUSIONS Evidence supporting the notion of seizure-induced excitotoxicity is questionable in the studied reports of postictal MRI abnormalities.
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Affiliation(s)
- Eugenio Grillo
- Department of Pediatrics, Hospital Universitário-Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Department of Neurology, Hospital Infantil Joana de Gusmão, Florianópolis, SC, Brazil.
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MR screening of candidates for thrombolysis: How to identify stroke mimics? J Neuroradiol 2014; 41:283-95. [PMID: 25451670 DOI: 10.1016/j.neurad.2014.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 05/24/2014] [Accepted: 05/26/2014] [Indexed: 11/21/2022]
Abstract
Stroke mimics account for up to a third of suspected strokes. The main causes are epileptic deficit, migraine aura, hypoglycemia, and functional disorders. Accurate recognition of stroke mimics is important for adequate identification of candidates for thrombolysis. This decreases the number of unnecessary treatments and invasive vascular investigations. Correctly identifying the cause of symptoms also avoids delaying proper care. Therefore, this pictorial review focuses on what the radiologist should know about the most common MRI patterns of stroke mimics in the first hours after onset of symptoms. The issues linked to the accurate diagnosis of stroke mimics in the management of candidates for thrombolysis will be discussed.
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Ohe Y, Hayashi T, Deguchi I, Fukuoka T, Horiuchi Y, Maruyama H, Kato Y, Nagoya H, Uchino A, Tanahashi N. MRI abnormality of the pulvinar in patients with status epilepticus. J Neuroradiol 2014; 41:220-6. [PMID: 24485898 DOI: 10.1016/j.neurad.2013.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 08/30/2013] [Accepted: 09/05/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Recently, magnetic resonance imaging (MRI) abnormalities of the pulvinar in patients with epilepsy have received greater attention, but their occurrence and features have not been fully elucidated. Therefore, we investigated the clinical and radiological features of patients with epilepsy who presented MRI abnormalities of the pulvinar. PATIENTS AND METHODS We retrospectively investigated 225 consecutive patients who came to our institute because of seizures and underwent an MRI within 24h. The patients who exhibited pulvinar MRI abnormalities, their profile, seizure type, efficacy of medication, and chronological changes of MRI findings were examined. RESULTS Out of the 225 patients who underwent MRI within 24h of seizure, 17 exhibited MRI abnormalities of the pulvinar. All of these 17 patients presented status epilepticus. Bilateral pulvinar diffusion-weighted imaging (DWI) hyperintensity was observed in 3 patients and unilateral pulvinar DWI hyperintensity in the other 14. Out of these 14 patients, 7 exhibited DWI hyperintensity in the ipsilateral cerebral cortex, and 10 patients presented an old lesion due to stroke or trauma. CONCLUSIONS Our results demonstrated that the involvement of the pulvinar in status epilepticus is more frequent than expected and consisted of unilateral or bilateral DWI hyperintensities that may completely normalize. These pulvinar MRI abnormalities possibly reflect the epileptogenic hyperexcitation of different cortical areas through their connections with the pulvinar.
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Affiliation(s)
- Yasuko Ohe
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.
| | - Takeshi Hayashi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Ichiro Deguchi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Takuya Fukuoka
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yousuke Horiuchi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hajime Maruyama
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yuji Kato
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Harumithu Nagoya
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Akira Uchino
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Japan
| | - Norio Tanahashi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
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Auffray-Calvier E, Toulgoat F, Daumas-Duport B, Lintia Gaultier A, Desal H. Infectious and metabolic brain imaging. Diagn Interv Imaging 2012. [PMID: 23182980 DOI: 10.1016/j.diii.2012.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Central nervous system infectious and metabolic disease is a vast domain. We have chosen to focus particularly on five pathological conditions: brain abscess, herpes encephalitis, Creutzfeldt-Jacob disease, posterior reversible encephalopathy and central pontine myelinolysis. We will pay particular attention to MRI signs and the specific sequences to use in each condition, in addition to the conventional sequences, in order to avoid diagnostic traps. Once the MRI exploration is complete, the diagnosis still cannot be established without knowing the clinical and metabolic context.
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Affiliation(s)
- E Auffray-Calvier
- Diagnostic and Interventional Neuroradiology Department, Hôpital René et Guillaume-Laënnec, CHU de Nantes, Saint-Herblain, France.
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Grillo E. Peri-ictal magnetic resonance imaging signal abnormalities: do they exist? Pediatr Neurol 2012; 46:137; author reply 137-8. [PMID: 22264712 DOI: 10.1016/j.pediatrneurol.2011.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Savage LM, Hall JM, Vetreno RP. Anterior thalamic lesions alter both hippocampal-dependent behavior and hippocampal acetylcholine release in the rat. Learn Mem 2011; 18:751-8. [PMID: 22086393 DOI: 10.1101/lm.023887.111] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The anterior thalamic nuclei (ATN) are important for learning and memory as damage to this region produces a persistent amnestic syndrome. Dense connections between the ATN and the hippocampus exist, and importantly, damage to the ATN can impair hippocampal functioning. Acetylcholine (ACh) is a key neurotransmitter in the hippocampus, and in vivo measures of ACh are correlated to learning and memory performance. In the present study, complete lesions of the ATN impaired performance on two measures of hippocampal-dependent learning and memory (spontaneous alternation and delayed alternation) and severely disrupted behaviorally evoked ACh efflux within the hippocampus of adult male rats. In contrast, incomplete ATN lesions did not impair spontaneous alternation performance but did impair delayed alternation performance while blunting hippocampal ACh efflux. Interestingly, ATN lesions of any size did not affect basal concentrations of ACh in the hippocampus. These results demonstrate that the ATN have the capacity to modulate behaviorally relevant neuronal transmission within the hippocampus.
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Affiliation(s)
- Lisa M Savage
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton, New York 13902, USA.
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Grillo E. Questionable direct association between ictal activity and thalamus lesions. Neuroradiology 2010; 53:69-70; author reply 71-2. [PMID: 21088963 DOI: 10.1007/s00234-010-0796-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 10/27/2010] [Indexed: 10/18/2022]
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Response to “letter to the editor” concerning our recently published article “Thalamus lesions in chronic and acute seizure disorders” Neuroradiology. 2010 Jun 29. [in press]. Neuroradiology 2010. [DOI: 10.1007/s00234-010-0797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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