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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To localize the neural correlates of musicogenic epilepsy, subtraction ictal SPECT coregistered with MRI (SISCOM) and (18)F-fluorodeoxy glucose positron emission tomography (FDG-PET) were performed in a woman who had suffered from frequent musicogenic seizures. She had complex partial seizures consisting of palpitation and an unpleasant feeling, which were followed by staring and oroalimentary automatisms. Ictal EEG showed rhythmic theta waves originated from the right temporal lobe, and SISCOM showed ictal hyperperfusion on right insula, amygdala, hippocampal head, and anterior temporal lobe, whereas interictal FDG-PET showed interictal hypometabolism in the same brain regions, suggesting dysfunction and abnormal activation of right temporo-limbic structures related to an emotional response to music.
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PMID:Neural correlates of musicogenic epilepsy: SISCOM and FDG-PET. 1803 23

Temporal lobe epilepsy (TLE) is associated with modification in thalamic structure and function. In particular, thalamic atrophy and hypometabolism can occur, affecting ipsilateral, contralateral thalami or both. We describe a 28-year-old epileptic woman, who presented peculiar neuroimaging findings, with enlargement of the thalamus contralateral to the epileptic focus. The patient was born from dystocic delivery, she presented partial motor seizures in the left side of the body, followed by generalisation, and the EEG showed a right temporal epileptic focus. Serial CT and MRI scan, performed along 11 years, showed a non-evolutive left thalamomegaly. 18-FDG PET showed reduced metabolic activity in the upper right temporal gyrus and in the ipsilateral thalamus. Thalamic asymmetry in our patient could be an occasional finding.
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PMID:Left thalamomegaly in a patient with partial epilepsy. 1809 11

Near-infrared spectroscopy (NIRS) is a novel imaging technique of potential value in the pre-surgical investigation of patients with refractory epilepsy. We recorded simultaneously electrophysiology (EEG; Compumedics, USA) and near-infrared spectroscopy (NIRS; ISS, USA) to examine the localization of the ictal onset zone and assess language lateralization in a young epileptic boy (L.H., 10 years) as part of his pre-surgical evaluation. L.H. underwent a prolonged EEG-NIRS recording while electro-clinical and electrical seizures were recorded. Results were compared to those obtained with other pre-surgical techniques (SPECT, FDG-PET, EEG-fMRI and EEG-MEG) and showed good concordance for ictal onset zone localization. A second NIRS session without EEG was carried out in order to investigate language lateralization. For this purpose, the patient performed a categorical verbal-fluency task during NIRS recordings. Results showed left-hemisphere dominance for language function in this young boy. This case report illustrates that multi-channel EEG-NIRS has the potential to contribute favourably to pre-surgical investigation in young patients.
Seizure 2008 Sep
PMID:Non-invasive pre-surgical investigation of a 10 year-old epileptic boy using simultaneous EEG-NIRS. 1837 8

Although PET imaging has been available for more than two decades, its use has greatly increased lately due to the advent of PET/CT, readily available sources of commercially supplied FDG, and mobile scanners. These features have enabled PET scanning to expand beyond select major university medical centers, with on-site cyclotron facilities to smaller institutions including free- standing children's hospitals. In these settings, imaging is generally limited to FDG, which suffices for most applications, with the majority of studies performed for tumor imaging. FDGI is being used for evaluation of many tumors in children, with its use in lymphoma being the most established. In lymphoma, it has proven quite useful in determining whether active tumor is present in residual masses following treatment, which may otherwise contain only residual fibrous tissue. For brain tumors, FDGI has some relation to tumor grade, although its more important role is distinguishing recurrent or residual tumor from the effects of treatment, particularly radiation necrosis. For neurological evaluation, interictal FDGI is helpful in localizing potential seizure foci for subsequent subdural EEG monitoring. Because of the relatively long uptake time of FDG, true ictal studies cannot be performed with FDG, and these remain within the domain of SPECT imaging of tracers such as Tc-99m HMPAO. Examinations utilizing radiopharmaceuticals other than FDG are significantly more limited in their availability and are limited to PET centers with on-site cyclotrons. However, these additional agents open the door to many additional studies, including more specific tumor-imaging agents of certain tumors such as neuroblastoma. Another neurotransmitter, F-18-fluoro-L-dopa, is of benefit outside of the central nervous system for evaluating infantile hyperinsulism. The use of PET/CT in children is increasing quickly, particularly FDGI imaging of tumors. It is expected that over the next few years, its role will become increasingly better defined.
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PMID:Positron emission tomography/computed tomography (PET/CT) in children. 1861 94

We present herein the case of a patient with a focal orbital frontal lesion on magnetic resonance imaging (MRI), but an insular onset of seizures. A 15-year-old boy suffered from hypermotor seizures for 9 years. In his seizures, he initially had a sensation that sounds were distant, and then his consciousness became impaired. After a short period of tonic activity, violent activities occurred, such as kicking or gripping some objects and shaking. MRI showed a focal cortical abnormality in the right orbital frontal lobe. [(18)F]FDG-PET revealed diffuse hypometabolism in the right frontal lobe, especially in the same site as the cortical lesion on MRI. The seizure onset zone was localized in the right anterior insula by intracranial recording. A resection of the right anterior insula and a partial disconnection of the frontal lobe were performed, rendering the patient seizure-free.
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PMID:A hypermotor seizure with a focal orbital frontal lesion originating in the insula: a case report. 1876 Sep 3

The functional changes that occur throughout the human brain after the selective removal of an epileptogenic lesion remain unclear. Subtemporal selective amygdalohippocampectomy (SAH) has been advocated as a minimally invasive surgical procedure for patients with medically intractable mesial temporal lobe epilepsy (MTLE). We evaluated the effects of subtemporal SAH on cerebral glucose metabolism and memory function in 15 patients with medically intractable MTLE with hippocampal sclerosis using [(18)F]-fluorodeoxyglucose PET (FDG-PET) and the Wechsler Memory Scale-Revised. The patients were evaluated before and 1-5 years (mean 2.6 years) after surgery. In patients with MTLE of the language-dominant hemisphere, the basal temporal language area was preserved by this surgical approach. Voxel-wise comparison of FDG-PET images was conducted using SPM5 to identify the brain regions showing postoperative changes in glucose metabolism (height threshold, P = 0.01 corrected for multiple comparisons; extent threshold, 100 voxels). During spatial normalization of the postoperative FDG-PET images, we used cost-function masking to minimize any inappropriate image distortion as a result of the abnormal signal within the surgically resected region. Postoperative glucose metabolism increased in extratemporal areas ipsilateral to the affected side, such as the dorsolateral prefrontal cortex, and the dorsomedial and ventromedial frontal cortices. Glucose metabolism also increased in the bilateral inferior parietal lobules and in the remaining temporal lobe regions remote from the resected mesial temporal region, such as the superior temporal gyrus and the temporal pole. By contrast, postoperative glucose metabolism decreased only in the mesial temporal area adjacent to the resected region. Postoperative verbal memory, delayed recall and attention/concentration scores were significantly better than preoperative scores regardless of the resected side. This study suggests that the selective removal of the epileptogenic region in MTLE using a subtemporal approach improved cerebral glucose metabolism in the areas receiving projections from the affected mesial temporal lobe. Cognitive improvement might result from a combination of good seizure control and minimizing the regions of the brain with postoperative functional impairment.
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PMID:Improved cerebral function in mesial temporal lobe epilepsy after subtemporal amygdalohippocampectomy. 1879 Aug 18

A Yorkshire terrier and a Chihuahua were referred for acute onset, generalized tonic-clonic seizures and were suspected to have meningoencephalitis based on magnetic resonance (MR) imaging findings. Brain lesions appeared hyperintense with T2-weighted imaging and hypointense with T1-weighted imaging, and were characteristic of necrotizing meningoencephalitis. Both dogs were diagnosed with necrotizing meningoencephalitis based on pathologic findings. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) was performed on both animals before euthanasia with the permission of the owner. In FDG-PET images, these lesions seen in MR images were characterized by multifocal or diffuse hypometabolism. Our FDG-PET results provided evidence of glucose hypometabolism in areas of necrosis and cavitation associated with necrotizing meningoencephalitis. FDG-PET has the potential to provide valuable diagnostic information in dogs with suspected necrotizing encephalitis.
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PMID:Positron emission tomography features of canine necrotizing meningoencephalitis. 1905 53

We report a 23-year-old woman who slowly developed progressive tremulous myoclonus and rare convulsive seizures beginning at the age of 9 and 11 years, respectively. She also showed a mild degree of ataxia and cognitive dysfunction. Convulsive seizures were well suppressed by valproic acid since the age of 17 years, but tremulous myoclonus gradually progressed and became rather intractable in spite of treatment by clonazepam and piracetam. Her cognitive dysfunction was mild (total IQ score in Wechsler Adult Intelligence Scale Revised being 85 points). In addition, she had a fear of walking which disabled her in the daily life although she could actually walk without assistance. The brain MRI showed a mild cerebellar atrophy, and FDG-PET showed a mild hypometabolism in the cerebellar hemispheres. Somatosensory evoked potentials (SEPs) showed enlarged P25 and N33 amplitudes (giant SEPs). A Cystatin B gene analysis exhibited a homozygous expansion of the dodecamer repeat, and thus we made a diagnosis of Unverricht-Lundborg disease (ULD). We also did gene analysis and SEP study to her parents after written informed consents were obtained. They had heterozygous expansion of the dodecamer repeat. The mother also showed enlarged P25 and N33 amplitudes, whereas the father showed normal amplitudes. It is known that degree of clinical symptoms varies among patients with ULD diagnosed by gene analysis. Gene analysis was helpful for a diagnosis of ULD in this patient because the ataxia and cognitive dysfunction were much milder than those commonly seen in patients with ULD.
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PMID:[Unverricht-Lundborg disease manifesting tremulous myoclonus with rare convulsive seizures: a case report]. 1922 96

The lithium-pilocarpine model of epilepsy in rat has been used extensively to investigate basic mechanisms of epilepsy and mimics human temporal lobe epilepsy. Our aim was to investigate longitudinal alterations in metabolism after lithium-pilocarpine induced status epilepticus (SE) using [(18)F]FDG microPET. Twenty-eight Wistar rats received lithium chloride followed by pilocarpine (n=19) or saline (n=9) IP. Continuous video-EEG was used to monitor SE and occurrence of spontaneous seizures (SS). FDG microPET imaging was performed at baseline, on day 3 after drug administration (D3), and at the end of the monitoring period (CR). MicroPET images were spatially normalized to Paxinos space and parametric standardized uptake value (SUV)-images were generated. Metabolism was compared between groups of animals and between different time points. Eighteen animals developed SE, 11 had died by D3. SS were recorded in 3 of 7 surviving SE animals. On D3, metabolism was reduced in SE group compared to controls throughout the brain (-49+/-27%), except for the cerebellum: mostly in hippocampus, entorhinal cortex and thalamus bilaterally. Metabolism tended to be different between SS and no SS animals on D3 in striatum and hippocampus. In CR condition, relative metabolism was significantly different in SE group compared to controls in cerebellum and brainstem bilaterally and left striatum and entorhinal cortex. There were no significant differences between SS and no SS animals in CR condition. Pilocarpine-induced SE causes a severe, but transient reduction in overall metabolism on D3 in rat brain. Metabolic differences on D3 between SS and no SS animals need further study to investigate potential use as an early marker of epileptogenesis.
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PMID:Longitudinal microPET imaging of brain glucose metabolism in rat lithium-pilocarpine model of epilepsy. 1964 37

A 37-year-old male and a 12-year-old female presented with non-lesional epilepsy arising from the supplementary motor area in the medial frontal cortex, manifesting as daily brief tonic seizures involving the bilateral extremities, which were intractable to multiple antiepileptic medications. During the seizure, there was no impairment of awareness, and the tonus was always higher in the limbs contralateral to the epileptogenic hemisphere in both patients. Scalp EEG detected midline epileptiform discharges. Three-tesla MR imaging using the FLAIR and short tau inversion recovery sequences, interictal IMP-SPECT, IMZ-SPECT, and FDG-PET detected no focal abnormalities in either patient. Invasive intracranial EEG evaluation was performed using chronically implanted subdural electrodes on the interhemispheric frontoparietal cortices, based mainly on the seizure semiology and the associated EEG findings. Intracranial EEG successfully identified the location of the seizure onset in the supplementary motor area in the medial frontal cortex. Focal cortical resection including the area of seizure onset resulted in freedom from seizures and significant improvement in both patients. Histological study revealed focal cortical dysplasia in both patients. Recognition of the typical seizure semiology is very important in the correct diagnosis and surgical treatment of supplementary motor area epilepsy, especially in the absence of MR imaging lesions.
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PMID:[Surgical treatment of non-lesional supplementary motor area epilepsy: two case reports]. 1930 50


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