Peri-ictal signal changes in seven patients with status epilepticus: interesting MRI observations
Peri-ictal signal changes in seven patients with status epilepticus: interesting MRI observations
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DOI：
10.1007/s00234-008-0479-2
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发表时间：
2009-03-01
期刊：
影响因子：
2.8
通讯作者：
Shivshankar, Jai Jai
中科院分区：
文献类型：
--
作者：
Goyal, Manoj K.;Sinha, Sanjib;Shivshankar, Jai Jai
在癫痫持续状态（SE）后，影像学上的短暂性周周改变已被描述，但其原因尚不清楚。我们分析了SE患者的磁共振成像（MRI）结果，以阐明包括周周信号在内的这些变化。这项前瞻性研究纳入了34例经历SE的患者（M/F 23:11，平均年龄25.8±17.2岁）。在癫痫发作停止期间或96小时内进行MRI检查。全身性癫痫状态25例（GCSE， 10例继发性GCSE， 15例原发性GCSE）。连续部分性癫痫7例，非惊厥性SE 2例。8例患者有癫痫发作史，3例患者既往有SE。MRI前SE的平均持续时间为89.2 +/- 105.3小时（范围2-360小时）。MRI诊断了17例患者，其中13例未发现结构性原因。7例（20.6%）SE患者（全身性惊厥，3例；部分性惊厥，3例；非惊厥，1例）在表观弥散系数图上出现局限性弥散的围周局灶信号改变。3/10（30%）患者在SE期间、1/7（14.3%）、1/5（20%）、1/6（16.7%）、1/6（16.7%）或1/6（16.7%）患者停止癫痫发作后24小时（14.3%）、48小时（20%）、72小时（16.7%）或96小时（16.7%）进行MRI检查时观察到这些变化。重复MRI显示2例患者信号改变消失。弥散受限的周围MR改变似乎是SE的结果而不是原因。
Transient peri-ictal changes on imaging had been described following status epilepticus (SE), but its cause is not very well understood. We analyzed the magnetic resonance imaging (MRI) findings in SE patients in order to elucidate such changes including peri-ictal signal.This prospective study involved 34 patients (M/F 23:11, mean age 25.8 +/- 17.2 years) who experienced SE. MRI was performed during or within 96 h of cessation of seizures. Twenty-five patients had generalized convulsive status epilectus (GCSE; ten secondary GCSE and 15 primary GCSE). Seven patients had epilepsia partialis continua and two patients non-convulsive SE. Eight patients had a history of seizures and three patients previous SE. The mean duration of SE prior to MRI was 89.2 +/- 105.3 h (range 2-360 h). MRI provided diagnosis in 17 patients, and in 13 patients, no structural cause was identified.Peri-ictal focal signal changes with restricted diffusion on apparent diffusion coefficient maps were present in seven (20.6%) patients with SE (generalized convulsive, three; partial, three; non-convulsive, one). The changes were observed when MRI was performed during SE in 3/10 (30%) patients, or within 24 h in 1/7 (14.3%), 48 h in 1/5 (20%), 72 h in 1/6 (16.7%), or 96 h in 1/6 (16.7%) patients after cessation of seizures. Repeat MRI revealed disappearance of signal changes in two patients.Peri-ictal MR changes with restricted diffusion appear to be an effect rather than the cause of SE.