Manuel Requena1, Silvana Sarria-Estrada2, Estevo Santamarina3, Manuel Quintana3, María Sueiras4, Alex Rovira5, Manuel Toledo3. 1. Epilepsy Unit, Neurology Department, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona Spain; Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Neuroradiology Section, Radiology Department, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona Spain; Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: silvana.sarria@idi.gencat.cat. 3. Epilepsy Unit, Neurology Department, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona Spain. 4. EEG Unit, Neurophysiology Department, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona Spain. 5. Neuroradiology Section, Radiology Department, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona Spain.
Abstract
PURPOSE: Magnetic resonance imaging (MRI) changes associated with status epilepticus (SE) have been described in recent studies. Our aim was to evaluate the diagnosis and prognosis of the peri-ictal MRI changes detected in SE patients. METHOD: All adults diagnosed with SE and examined by MRI within 240 h after SE onset were enrolled (2011-2017). Demographic, clinical and electroencephalography data, and functional status at admission and discharge were collected. MRI findings were recorded and relationships between clinical and MRI data, and between these data and functional outcome were analyzed. RESULTS: Sixty patients included, 50% women, mean age 57.5 years. Median duration of SE was 51.46 h and median time from SE onset to MRI was 86.5 h. Of the total, 41.7% had a restricted diffusion pattern on diffusion-weighted imaging (DWI) and 63.3% had hyperintensities suggestive of edema on T2-weighted (T2WI)/FLAIR sequences. The factors independently associated with T2WI hyperintensities were the presence of acute cerebral lesions (p = 0.023), baseline STESS (p = 0.007), and MRI performed within 84 h (p = 0.007). Variables independently associated with diffusion restriction were a potentially fatal cause (p = 0.020), SE duration >24 h (p = 0.022), and MRI performed within the first 84 h (p = 0.045). In patients undergoing MRI within 84 h, the DWI and T2WI abnormalities were both highly associated with an unfavorable outcome. CONCLUSIONS: Characteristic signal changes on DWI and T2WI sequences were seen in approximately half our SE patients undergoing early (<84 h) brain MRI studies, and were independently related to the patients' functional status at discharge.
PURPOSE: Magnetic resonance imaging (MRI) changes associated with status epilepticus (SE) have been described in recent studies. Our aim was to evaluate the diagnosis and prognosis of the peri-ictal MRI changes detected in SE patients. METHOD: All adults diagnosed with SE and examined by MRI within 240 h after SE onset were enrolled (2011-2017). Demographic, clinical and electroencephalography data, and functional status at admission and discharge were collected. MRI findings were recorded and relationships between clinical and MRI data, and between these data and functional outcome were analyzed. RESULTS: Sixty patients included, 50% women, mean age 57.5 years. Median duration of SE was 51.46 h and median time from SE onset to MRI was 86.5 h. Of the total, 41.7% had a restricted diffusion pattern on diffusion-weighted imaging (DWI) and 63.3% had hyperintensities suggestive of edema on T2-weighted (T2WI)/FLAIR sequences. The factors independently associated with T2WI hyperintensities were the presence of acute cerebral lesions (p = 0.023), baseline STESS (p = 0.007), and MRI performed within 84 h (p = 0.007). Variables independently associated with diffusion restriction were a potentially fatal cause (p = 0.020), SE duration >24 h (p = 0.022), and MRI performed within the first 84 h (p = 0.045). In patients undergoing MRI within 84 h, the DWI and T2WI abnormalities were both highly associated with an unfavorable outcome. CONCLUSIONS: Characteristic signal changes on DWI and T2WI sequences were seen in approximately half our SE patients undergoing early (<84 h) brain MRI studies, and were independently related to the patients' functional status at discharge.
Authors: Kenji Ibayashi; Araceli R Cardenas; Hiroyuki Oya; Hiroto Kawasaki; Christopher K Kovach; Matthew A Howard; Michael A Long; Jeremy D W Greenlee Journal: World Neurosurg Date: 2020-12-08 Impact factor: 2.104
Authors: Aran Nagendran; James Fraser McConnell; Luisa De Risio; Roberto José-López; Rodrigo Gutierrez Quintana; Kelsey Robinson; Simon R Platt; Daniel Sanchez Masian; Thomas Maddox; Rita Gonçalves Journal: J Vet Intern Med Date: 2021-02-09 Impact factor: 3.333