Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-one ECD (Technetium-99m-ethyl cysteinate dimer) SPECT investigations were undertaken in the course of a presurgical diagnostic work-up in 23 patients with pharmacoresistant focal epilepsy. In 21 patients, both an ictal and interictal SPECT were conducted. In the patients receiving ictal SPECT the tracer was injected between 7 and 30 s after the seizure onset. Of the interictal SPECTs 17 of 23 showed focal hypoperfusion which was consistent in 17 cases (74%) with the area of the electrophysiological focus (EF) and 6 patients had a normal interictal SPECT. Of the ictal SPECTs 18 of 21 (86%) showed regional hyperperfusion, 18 of them in the same location as the EF. Ictal SPECT showed a hypoperfusion similar to that in interictal SPECT in another 3 patients. In these cases seizure duration was short (28-54 s), so that the tracer reached the brain postictally. Our results show that ictal ECD-SPECT is an effective method for demonstrating an epileptogenic focus. Possible reasons for false-negative ictal SPECT results are discussed.
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PMID:Ictal and interictal ECD-SPECT for focus localization in epilepsy. 940 95

We reported two cases of two-year-old girls with hypoxic ischemic encephalopathy. Their symptom was coma induced by seizures with respective factors. CT image on subacute stage showed the decreased density of the whole brain except for the primary sensorimotor cortex and the occipital lobe. MRI and CT images on chronic stage revealed generalized atrophy with no abnormal density areas. 99mTc-ECD SPECT on chronic stage showed low perfusion in the whole brain except for the primary sensorimotor cortex and the occipital lobe, in which areas brain tissue is considered to be injured easily in hypoxic ischemic encephalopathy. The paradoxical distribution of abnormal cerebral perfusion areas in our cases was reported in this paper.
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PMID:[Two cases of two-year-old girls with hypoxic ischemic encephalopathy induced by convulsive status]. 959 89

Ictal SPECT is a highly sensitive method to localize the epileptogenic focus in refractory temporal lobe epilepsy in adults. In extratemporal epilepsy, sensitivity can be improved by subtracting interictal from ictal images and superimposing subtraction images on MRI. In children, such a procedure is potentially interesting because most epilepsies are extratemporal and ictal SPECT not yet routinely developed. The aim of this study was to test the feasibility of ictal SPECT with subtraction image processing in a pediatric population. Twenty-six children with refractory partial epilepsy and aged from 3 months to 18 years underwent ictal ECD-SPECT (20 mCi/1.73 m2) combined with video-EEG and interictal ECD-SPECT plus 3D-MRI two days later. Ictal-interictal subtraction images were computed by registering and normalizing the ictal to the interictal SPECT scans for each child. The ictal, interictal SPECT and subtraction images were registered to the children's MRI. Difference images were then superimposed to MRI for anatomical localization of the perfusion changes (overlay images). Looking for perfusion changes, overlay images allowed to detect at least one hyperperfused focus in 92 p. 100 of the 26 children compared to 73 p. 100 visually comparing ictal and interictal scans separately. Seizure onset was suspected on clinical and/or EEG and/or MRI in 19 children. Positive overlay images were concordant (n = 11) or larger (n = 7) than the suspected focus in 17/19 (90 p. 100), whereas they failed to show any abnormality in 1 child and were discordant with MRI in another one. In the 7 remaining patients, images showed cortical localization in 6 cases. Ictal SPECT is therefore faisable in very young children. Ictal-interictal subtraction SPECT images co-registered to MRI improves sensitivity compared to classical visual analysis. It seems therefore to be a helpful technique to localize the onset of seizure and to guide the intracranial recording in childhood epilepsy.
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PMID:[Ictal SPECT in the epileptic child. Contribution of subtraction interictal images and superposition of with MRI]. 1047 63

Postictal psychoses are brief psychotic episodes that usually occur after poorly controlled partial complex seizure clusters. The psychosis commonly appears following a lucid interval, ranging from a few hours to days after seizure termination. An underlying structural brain abnormality is common and usually involves the temporal lobe. Postictal psychosis, while well known in adults, has not been described previously in children. We describe a 9-year-old boy with right hemiparesis due to a neonatal stroke, who developed a postictal schizophrenia-like psychosis following status epilepticus. Electroencephalography showed left-sided slowing. A brain computed tomographic scan and magnetic resonance imaging revealed left hemisphere hypoplasia. A 99mTc-ECD single photon emission computed tomographic scan of the brain revealed decreased left-hemisphere perfusion, most pronounced to the medial temporal lobe. The psychosis resolved gradually over 7 days without antipsychotic therapy. To the best of our knowledge, this is the first description of postictal psychosis in a child.
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PMID:Postictal psychosis in a child. 1061 70

We studied six patients with focal cortical dysplasia (CD) and four patients with dysembryoplastic neuroepithelial tumor (DNT) who had surgical resection for medically intractable epilepsy. In all CD patients, ictal single photon emission computed tomography (SPECT) using 99mTc-ECD revealed hyperperfusion in the regions where magnetic resonance (MR) imaging showed CD abnormalities. Interictal epileptiform activity and ictal seizure onset on electrocorticography using subdural strip or grid electrodes were demonstrated in the CD itself. In contrast, in all DNT patients, interictal SPECT disclosed hypoperfusion in the area of the lesions. Ictal SPECT in one DNT patient disclosed hyperperfusion in the superior area of the region where MR imaging showed cystic abnormalities. Interictal spiking in all DNT patients and ictal seizure onset in two DNT patients were demonstrated not in the lesions themselves but in the distinct zone from the region of the tumor-involved brain. All CD patients who underwent lesionectomy became seizure-free with a mean follow-up period of 33.5 months. All DNT patients who underwent lesionectomy and resection of the epileptogenic cortex became seizure-free or had their seizure significantly reduced a mean follow-up period of 41.5 months. We conclude that CDs have intrinsic epileptogenicity, while DNTs have epileptogenicity not intrinsically but in encompassed cortical surface areas.
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PMID:[Epilepsy surgery for focal cortical dysplasia and dysembryoplastic neuroepithelial tumor]. 1066 33

Body rotation during partial epileptic seizures remains a poorly understood clinical feature, possibly related to the ictal involvement of specific cortical areas (e.g. vestibular cortex). However, there are both experimental and clinical arguments which support the hypothesis of basal ganglia asymmetric activation during such complex motor behavior. We report a patient exhibiting rotational seizures which proved to arise from right anterior temporal lobe structures and the orbito-cingular cortex, as demonstrated during stereotactic EEG recordings. An ictal 99mTc-ECD-SPECT study was performed during an electrically induced seizure, similar to the seizures usually experienced by the patient but without a rotatory component, showing a marked increase of cerebral blood flow in the lenticular nucleus, ipsilaterally to the epileptogenic area. This finding suggests that lenticulate involvement might be necessary to produce an ictal circling behavior. As circling behavior can be observed during epileptic seizures originating from areas widely distributed in the cortex, one may postulate that the basal ganglia involvement is the "final common pathway" underlying the rotational part of the clinical symptomatology.
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PMID:Basal ganglia involvement in rotational seizures. 1095 45

Ictal SPECT is a valuable method for the presurgical exploration of partial epilepsy. (99m)Tc Ethyl Cysteinate Dimer stable during 6h has contributed to develop ictal studies to evaluate the location of partial seizure. The aim of this study was to investigate some factors playing a possible role on the regional increase of cerebral blood flow (rCBF) Twenty-three patients with refractory partial epilepsy (temporal epilepsy n=16, extratemporal epilepsy n=7) were included. All the patients underwent a presurgical evaluation (phase I) during a week with detailed clinical history, cranial magnetic resonance imaging, monitoring EEG and video. Ictal and interictal SPECT were performed using a fast rotating brain dedicated camera (TOMOMATIC 564) in a quiet and normally illuminated room with controlled EEG (interictal) or video EEG (ictal); Scanning was started one hour after injection of ECD Tc administered in IV a few seconds after the electrical onset seizure. Slices parallel to the long axis of the temporal lobe were reconstructed. SPECT images were evaluated after normalisation. This study shows that
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PMID:[Factors playing a role in the increase of localized perfusion observed by single-photon emission-computed tomography during an epileptic seizure]. 1113 27

A 24-year-old male of medial temporal lobe epilepsy associated with schizencephaly was presented. He developed complex partial seizure after head trauma at the age of a year and 7 months, which became intractable at the age of 13 year. MRI demonstrated a schizencephalic cleft in the right peri-Rolandic area, cortical dysplasia in the right medical parietal and occipital lobes, and right hippocampal atrophy. Scalp-recorded EEG failed to localize the ictal onset zone. Interictal FDG-PET and ECD-SPECT indicated hypometabolism and hypoperfusion of the right entire temporal lobe, and ictal ECD-SPECT increased perfusion of this area. Chronic subdural electrode recording clearly demonstrated that ictal onset zone was located not on the schizencephalic cleft or its surrounding cortex but on the right medial temporal lobe. Following right anterior temporal lobectomy with hipppocampectomy, seizure control became easy. For the identification of the epileptogenic zone in patients with schizencephaly, chronic subdural electrode recording is mandatory.
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PMID:[An operated case of medial temporal lobe epilepsy associated with schizencephaly]. 1129 7

We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL.
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PMID:[Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy]. 1143 41

The purpose of this study is to investigate if multimodality neuroimaging evaluation increases the detection of subtle focal cortical dysplasia as part of an epilepsy surgery evaluation. Three patients with normal magnetic resonance imaging and histopathological findings of focal cortical dysplasia were reviewed. Their magnetoencephalography recordings were performed on whole-head magnetoencephalography system. Magnetic resonance images were re-evaluated with special inspection in limited regions guided by magnetoencephalography spike localization. Two patients had ictal and interictal single photon emission computed tomography study after administration of Tc99m ECD. In two patients we found tiny focal abnormalities including slightly increased cortical thickness and blurred gray-white matter junction at the locations of interictal events after re-evaluation of the MR images indicating focal cortical dysplasia. The third patient showed focal atrophic change. All patients are seizure free after surgery. Both ictal and interictal single photon emission computed tomography showed hyperperfusion in the dysplastic cortex regions. Multimodality neuroimaging study can improve the detection of focal cortical dysplasia. Normal magnetic resonance images should be re-evaluated for subtle signs of focal cortical dysplasia especially when magnetoencephalography recording demonstrate focal epileptic discharges.
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PMID:Multimodality neuroimaging evaluation improves the detection of subtle cortical dysplasia in seizure patients. 1256 26


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