Magnetic resonance imaging (MRI) provides an opportunity for identifying peri-ictal MRI abnormalities (PMAs) related to status epilepticus (SE). Extremely variable MRI alterations have been reported previously during or after SE, mainly in small selected populations. In a retrospective monocentric study, we analyzed brain MRI changes observed in the ictal/postictal periods of SE in an adult population. We included all consecutive patients observed in a 5-year period with an electroclinical diagnosis of SE and an MRI performed within 30 days from the beginning of SE. We identified 277 patients. Among them, 32 (12%) showed PMAs related to SE. The duration of SE was strongly associated with MRI alterations, showing a mean duration of 6 days vs 2 days (P =.011) in the group with and without MRI alterations, respectively. Focal electroencephalography (EEG) abnormalities (P =.00003) and in particular, lateralized periodic discharges (LPDs) (P <.0001) were strongly associated with PMAs. MRI alterations were unilateral (23 patients, 72%), located in multiple brain structures (19 patients, 59%), and involving mesiotemporal structures (17 patients, 53%). Sixteen patients (50%) had good spatial correspondence between cortical PMAs and the focal EEG pattern; 12 patients (38%) with focal EEG pattern showed cortical PMAs plus MRI signal changes also involving subcortical structures. A follow-up MRI was available for 14 of 32 patients (44%): 10 patients presented a disappearance of PMAs, whereas in 4, PMAs were still present. This study demonstrates that a long duration SE and the presence of certain EEG patterns (LPDs) are associated with the occurrence of PMAs. A good spatial concordance was observed between cortical PMA location and the EEG focus.

Neuroimaging alterations related to status epilepticus in an adult population: Definition of MRI findings and clinical-EEG correlation / Giovannini, Giada; Kuchukhidze, Giorgi; McCoy, Mark R.; Meletti, Stefano; Trinka, Eugen. - In: EPILEPSIA. - ISSN 0013-9580. - 59:(2018), pp. 120-127. [10.1111/epi.14493]

Neuroimaging alterations related to status epilepticus in an adult population: Definition of MRI findings and clinical-EEG correlation

Giovannini, Giada;Meletti, Stefano;
2018

Abstract

Magnetic resonance imaging (MRI) provides an opportunity for identifying peri-ictal MRI abnormalities (PMAs) related to status epilepticus (SE). Extremely variable MRI alterations have been reported previously during or after SE, mainly in small selected populations. In a retrospective monocentric study, we analyzed brain MRI changes observed in the ictal/postictal periods of SE in an adult population. We included all consecutive patients observed in a 5-year period with an electroclinical diagnosis of SE and an MRI performed within 30 days from the beginning of SE. We identified 277 patients. Among them, 32 (12%) showed PMAs related to SE. The duration of SE was strongly associated with MRI alterations, showing a mean duration of 6 days vs 2 days (P =.011) in the group with and without MRI alterations, respectively. Focal electroencephalography (EEG) abnormalities (P =.00003) and in particular, lateralized periodic discharges (LPDs) (P <.0001) were strongly associated with PMAs. MRI alterations were unilateral (23 patients, 72%), located in multiple brain structures (19 patients, 59%), and involving mesiotemporal structures (17 patients, 53%). Sixteen patients (50%) had good spatial correspondence between cortical PMAs and the focal EEG pattern; 12 patients (38%) with focal EEG pattern showed cortical PMAs plus MRI signal changes also involving subcortical structures. A follow-up MRI was available for 14 of 32 patients (44%): 10 patients presented a disappearance of PMAs, whereas in 4, PMAs were still present. This study demonstrates that a long duration SE and the presence of certain EEG patterns (LPDs) are associated with the occurrence of PMAs. A good spatial concordance was observed between cortical PMA location and the EEG focus.
20-ago-2018
59
120
127
Neuroimaging alterations related to status epilepticus in an adult population: Definition of MRI findings and clinical-EEG correlation / Giovannini, Giada; Kuchukhidze, Giorgi; McCoy, Mark R.; Meletti, Stefano; Trinka, Eugen. - In: EPILEPSIA. - ISSN 0013-9580. - 59:(2018), pp. 120-127. [10.1111/epi.14493]
Giovannini, Giada; Kuchukhidze, Giorgi; Mccoy, Mark R.; Meletti, Stefano; Trinka, Eugen
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1167996
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