S A Jabeen1, Pavankumar Cherukuri2, Rukmini Mridula3, K R Harshavardhana4, Padmaja Gaddamanugu5, Sailaja Sarva6, A K Meena7, Rupam Borgohain8, Y Jyotsna Rani9. 1. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: drjabeennims@gmail.com. 2. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: drpavancherukuri@Gmail.Com. 3. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: rukminimridula@gmail.com. 4. Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: kr.harsha@gmail.com. 5. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: padmajagaddamanugu@Yahoo.Co.In. 6. Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: sailajasarva@hotmail.com. 7. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: meenaak@hotmail.com. 8. Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: rupam_b@hotmail.com. 9. Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: Email.yjyotsna@yahoo.com.
Abstract
OBJECTIVE: To study the frequency, imaging characteristics, and clinical predictors for development of periictal diffusion weighted MRI abnormalities. METHODS: We prospectively analyzed electro clinical and imaging characteristic of adult patients with cluster of seizures or status epilepticus between November 2013 and November 2015, in whom the diffusion weighted imaging was done within 24h after the end of last seizure (clinical or electrographic). RESULTS: There were thirty patients who fulfilled the inclusion and exclusion criteria. Twenty patients (66%) had periictal MRI abnormalities. Nine patients (34%) did not have any MRI abnormality. All the patients with PMA had abnormalities on diffusion weighted imaging (DWI). Hippocampal abnormalities were seen in nine (53%), perisylvian in two (11.7%), thalamic in five (30%), splenium involvement in two (11.7%) and cortical involvement (temporo-occipital, parieto-occipital, temporo-parietal, fronto-parietal and fronto-temporal) in sixteen (94.1%) patients. Complete reversal of DWI changes was noted in sixteen (80%) patients and four (20%) patients showed partial resolution of MRI abnormalities. Mean duration of seizures was significantly higher among patients with PMA (59.11+20.97h) compared to those without MRI changes (27.33+9.33h) (p<0.001). CONCLUSIONS: Diffusion abnormalities on MRI are common in patients with cluster of seizures and status epilepticus and were highly concordant with clinical semiology and EEG activity. Patients with longer duration of seizures/status were more likely to have PMA.
OBJECTIVE: To study the frequency, imaging characteristics, and clinical predictors for development of periictal diffusion weighted MRI abnormalities. METHODS: We prospectively analyzed electro clinical and imaging characteristic of adult patients with cluster of seizures or status epilepticus between November 2013 and November 2015, in whom the diffusion weighted imaging was done within 24h after the end of last seizure (clinical or electrographic). RESULTS: There were thirty patients who fulfilled the inclusion and exclusion criteria. Twenty patients (66%) had periictal MRI abnormalities. Nine patients (34%) did not have any MRI abnormality. All the patients with PMA had abnormalities on diffusion weighted imaging (DWI). Hippocampal abnormalities were seen in nine (53%), perisylvian in two (11.7%), thalamic in five (30%), splenium involvement in two (11.7%) and cortical involvement (temporo-occipital, parieto-occipital, temporo-parietal, fronto-parietal and fronto-temporal) in sixteen (94.1%) patients. Complete reversal of DWI changes was noted in sixteen (80%) patients and four (20%) patients showed partial resolution of MRI abnormalities. Mean duration of seizures was significantly higher among patients with PMA (59.11+20.97h) compared to those without MRI changes (27.33+9.33h) (p<0.001). CONCLUSIONS: Diffusion abnormalities on MRI are common in patients with cluster of seizures and status epilepticus and were highly concordant with clinical semiology and EEG activity. Patients with longer duration of seizures/status were more likely to have PMA.
Authors: Lukas Machegger; Pilar Bosque Varela; Giorgi Kuchukhidze; Jürgen Steinbacher; Andreas Öllerer; Tanja Prüwasser; Georg Zimmermann; Slaven Pikija; Johannes Pfaff; Eugen Trinka; Mark Mc Coy Journal: Front Neurol Date: 2022-07-07 Impact factor: 4.086
Authors: Annemarie Hübers; Katharina Thoma; Michael Schocke; Susanne Fauser; Albert C Ludolph; Jan Kassubek; Elmar H Pinkhardt Journal: Front Neurol Date: 2018-07-25 Impact factor: 4.003