Periictal diffusion abnormalities of the thalamus in partial status epilepticus.
Periictal diffusion abnormalities of the thalamus in partial status epilepticus.
复制标题
DOI：
10.1111/j.1528-1167.2008.01736.x
复制
发表时间：
2009-02
期刊：
影响因子：
5.6
通讯作者：
Mitsias PD
中科院分区：
文献类型：
--
作者：
Katramados AM;Burdette D;Patel SC;Schultz LR;Gaddam S;Mitsias PD
识别和描述颞叶和颞叶外癫痫持续状态（SE）患者的丘脑功能障碍，并分析急性丘脑受累患者的特定临床、放射学和EEG特征。我们回顾性地确定了在记录到偏侧癫痫样放电后五天内表现出部分SE临床和电图证据并在扩散加权成像（DWI）上出现丘脑异常的患者（第1组）。分析周期性偏侧癫痫样放电（PLED）和记录的电图癫痫发作的时空特征，并与MRI DWI高信号病变进行相关性分析。将第1组患者的结果与DWI上部分SE但无丘脑异常的患者（第2组）的结果进行比较。两组癫痫样放电的临床表现和形态相似。第1组患者在DWI上有丘脑高信号病变，出现在枕核区域，与癫痫样活动同侧。丘脑病变的存在与同侧皮质层受累（p=0.039）以及后象限癫痫发作起源（p=0.038）之间存在统计学显著相关性。还观察到PLED起源于后象限的趋势（p=0.077）。部分SE延长后可观察到丘脑DWI高信号病变，可能是与受累皮质相互连接的丘脑核团过度活动的结果。丘脑可能参与癫痫持续状态部分性发作的发展和传播。
To identify and describe thalamic dysfunction in patients with temporal as well as extratemporal status epilepticus (SE), and to also analyze the specific clinical, radiological and EEG characteristics of patients with acute thalamic involvement. We retrospectively identified patients who presented with clinical and electrographic evidence of partial SE and had thalamic abnormalities on diffusion-weighted imaging (DWI) within five days of documentation of lateralized epileptiform discharges (Group 1). The spatial and temporal characteristics of the periodic lateralized epileptiform discharges (PLEDs) and the recorded electrographic seizures were analyzed and correlated with MRI-DWI hyperintense lesions. The findings of Group 1 patients were compared with those of patients with partial SE without thalamic abnormalities on DWI (Group 2). The two groups were similar with regard to clinical presentation and morphology of epileptiform discharges. Group 1 patients had thalamic hyperintense lesions on DWI that appeared in the region of the pulvinar nucleus, ipsilateral to the epileptiform activity. Statistically significant relationship was noted between the presence of thalamic lesions and ipsilateral cortical laminar involvement (p=0.039) as well as seizure origin in the posterior quadrants (p=0.038). A trend towards PLEDs originating in the posterior quadrants was also noted (p=0.077). Thalamic DWI hyperintense lesions may be observed after prolonged partial SE and are likely the result of excessive activity in thalamic nuclei having reciprocal connections with the involved cortex. The thalamus likely participates in the evolution and propagation of partial seizures in status epilepticus.
登录
查看更多内容
影响因子：
14.5
作者：
Guye, Maxime;Regis, Jean;Bartolomei, Fabrice
通讯作者：
Bartolomei, Fabrice
影响因子：
5.6
作者：
Claassen, J;Hirsch, LJ;Mayer, SA
通讯作者：
Mayer, SA
影响因子：
9.9
作者：
Andrade, D. M.;Zumsteg, D.;Wennberg, R. A.
通讯作者：
Wennberg, R. A.
影响因子：
3
作者：
Assal, F;Papazyan, JP;Goerres, GW
通讯作者：
Goerres, GW
影响因子：
5.6
作者：
Mueller, SG;Laxer, KD;Weiner, MW
通讯作者：
Weiner, MW