共查询到20条相似文献，搜索用时 15 毫秒
1.
Maria Durce C. G. Carvalho Ricardo A. A. Ximenes Ulisses R. Montarroyos Paula F. S. da Silva Luciana P. A. Andrade-Valença Sophie H. Eickmann Regina C. Ramos Maria Ângela W. Rocha Thalia V. B. de Araujo Maria de Fátima P. M. de Albuquerque Celina M. T. Martelli Wayner V. de Souza Elizabeth B. Brickley Demócrito de B. Miranda-Filho 《Epilepsia》2020,61(3):509-518
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Taketoshi Maehara 《Neuropathology》2007,27(6):585-593
It can sometimes be difficult, when examining surgical specimens, to detect underlying pathological abnormalities that may account for disordered electrical activity. For accurate diagnosis, neuropathologists and clinicians need to share common preoperative information about resected brain tissue. Our group has been able to use structural, functional, and electrophysiological neuroimaging techniques to visualize epileptogenic areas preoperatively. MRI is the most sensitive and useful examination to demonstrate structural abnormalities in patients with partial or localization‐related epilepsy. Temporal lobe epilepsy, neoplastic lesions, vascular lesions, and developmental anomaly can all be surgically corrected under favorable circumstances. Functional neuroimaging by positron emission tomography (PET) and single‐photon emission computed tomography (SPECT) are useful tools for detecting epileptic foci. PET and SPECT demonstrate subtle functional changes related to epilepsy that ultimately may enable the detection of epileptogenic areas invisible to MRI. PET/SPECT images coregistered to MRI and statistical parametric mappings are of more value for detecting than PET/SPECT images alone. Electrophysiological neuroimaging with analytical software is very useful for visually understanding epileptogenic phenomena. Computerized voltage topographic mappings overlapped on three‐dimensional MRI with multichannel electrodes visually demonstrate ictal onset areas and seizure propagation. A new method of multimodal image‐guided intervention enables the detection of epileptogenic areas by electrocorticography, PET images, and MRI during epilepsy surgery. Neuropathologists using this method can collect precise structural, functional, and electrophysiological findings on surgical specimens. Neuroimaging of epilepsy is useful for visually clarifying structural, functional, and electrophysiological information on epilepsy patients. This approach is key for diagnosing the background pathological abnormalities of resected tissue. 相似文献
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Luiz E. Betting Li M. Li Iscia Lopes‐Cendes Marilisa M. Guerreiro Carlos A.M. Guerreiro Fernando Cendes 《Human brain mapping》2010,31(9):1327-1338
The objective of this study was to investigate the relationship between the focal discharges sometimes observed in the electroencephalogram of patients with idiopathic generalized epilepsies and subtle structural magnetic resonance imaging abnormalities. The main hypothesis to be assessed is that focal discharges may arise from areas of structural abnormality which can be detected by quantitative neuroimaging. Focal discharges were used for quantitative electroencephalogram source detection. Neuroimaging investigations consisted of voxel‐based morphometry and region of interest volumetry. For voxel‐based morphometry, volumetric MRI were acquired and processed. The images of each patient were individually compared with a control group. Statistical analysis was used to detect differences in gray matter volumes. Region of interest‐based morphometry was automatically performed and used essentially to confirm voxel‐based morphometry findings. The localization of the focal discharges on the electroencephalogram was compared to the neuroimaging results. Twenty‐two patients with idiopathic generalized epilepsies were evaluated. Gray matter abnormalities were detected by voxel‐based morphometry analysis in 77% of the patients. There was a good concordance between EEG source detection and voxel‐based morphometry. On average, the nearest voxels detected by these methods were 19 mm (mm) apart and the most statistically significant voxels were 34 mm apart. This study suggests that in some cases subtle gray matter abnormalities are associated with focal epileptiform discharges observed in the electroencephalograms of patients with idiopathic generalized epilepsies. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc. 相似文献
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BackgroundWe describe the brain magnetic resonance imaging (MRI) abnormalities and neuropathologic findings of patients with Sturge-Weber syndrome and medically refractory epilepsy.MethodsWe reviewed the clinical features, preoperative MRI studies, and pathologic findings of all patients with Sturge-Weber syndrome who underwent excisional surgery for intractable epilepsy at Boston Children's Hospital between 1993 and 2011.ResultsEleven patients (male/female = 4/7) with Sturge-Weber syndrome were identified who underwent surgery for intractable epilepsy (mean age 13 ± 6.2 months), including hemispherectomy (n = 10) and focal cortical resection (n = 1). Mean age at seizure onset was 15 ± 11 weeks. Fifty-five percent (n = 6) of patients exhibited two different types of seizures, and 18% (n = 2) had three types of seizures. Focal clonic seizures were the most common type, occurring in nine patients; apnea was the second most common, occurring in four patients. Brain MRIs were reviewed in five patients. Histopathologic examination revealed varied degrees of cortical morphologic anomaly in seven of 11 patients. Overall, there were no abnormalities in the MRIs that corresponded directly with the pathologic findings except in one patient with polymicrogyria.ConclusionsIn spite of pathologic findings of cortical anomalies in varied degrees, these findings could not be readily detected on brain MRIs. The failure to detect focal cortical dysplasia on MRIs may be attributable to the subtle microscopic nature of the abnormalities; in some of the older individuals, the imaging studies available for review were done during an advanced stage of the disease. 相似文献
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Sinead Culleton Giacomo Talenti Marios Kaliakatsos Suresh Pujar Felice D'Arco 《Epilepsia》2019,60(4):585-592
Febrile infection‐related epilepsy syndrome (FIRES) is a rare severe epileptic syndrome occurring in previously healthy children and characterized by refractory status epilepticus (SE) following a febrile illness. Brain imaging findings in affected patients have been reported in few case series and some case reports. This article is a comprehensive review of the magnetic resonance imaging (MRI) characteristics in all reported patients with a diagnosis of FIRES, describing the findings in the acute and chronic phases of the disease, and discussing possible pathogenesis and radiologic differential diagnoses. Most of the patients had normal brain scans in the acute phase (61%) and about 25% of the patients reported in literature had abnormalities in the temporal lobes. Changes in the basal ganglia and rarely in thalami or brainstem have also been described, as well as diffuse cerebral edema in a minority of patients during the acute phase. The chronic phase of the disease was characterized by atrophic changes and evidence of mesiotemporal sclerosis. An understanding of these MRI abnormalities is necessary to support the diagnosis of FIRES and exclude mimics. 相似文献
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Jerome Engel 《Epileptic Disord》2019,21(5):391-409
At the time of the first meeting of the International League Against Epilepsy (ILAE) in 1909, surgical treatment for epilepsy had been accepted as an alternative therapy for over two decades, but was rarely practiced, considered a last resort for carefully selected patients. Localization was based on ictal semiology and identification of a structural lesion. Very few papers on epilepsy surgery were presented at ILAE meetings or published in Epilepsia during the first half of the 20th century. A modest explosion in interest in epilepsy surgery at mid‐century resulted from recognition that “invisible” epileptogenic lesions could be identified by EEG, especially for temporal lobe epilepsy. Epilepsy surgery received a second boost in popularity toward the end of the 20th century with the advent of structural and functional neuroimaging, and the number of epilepsy centers worldwide doubled between the first Palm Desert conference in 1986 and the second Palm Desert conference in 1992. Neuroimaging also helped to increase application of surgical treatment to infants and young children with severe epilepsies. Epilepsy surgery was accepted as standard of care for drug‐resistant focal epilepsy and was well‐represented at international ILAE congresses and in Epilepsia. Advances continue into the 21st century with the introduction of laser ablation, and palliative neuromodulation approaches, which have greatly increased the population of patients who can benefit from surgery. Modern presurgical evaluation techniques have also made surgical treatment possible in many countries with limited resources. Three randomized control trials now have definitively proved the safety and efficacy of epilepsy surgery, however, this alternative therapy remains under‐utilized even in the industrialized world, where less than 1% of potential candidates are being referred to epilepsy centers. Furthermore, those who are referred receive surgery an average of 20 years after onset of epilepsy, often too late to avoid irreversible disability. The major challenges in realizing the full potential of epilepsy surgery, therefore, are not as much in the continued improvement of the treatment itself, as they are in addressing the treatment gap that is preventing appropriate patients from being referred to full‐service epilepsy centers. 相似文献
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Roulet-Perez E Ballhausen D Bonafé L Cronel-Ohayon S Maeder-Ingvar M 《Epilepsia》2008,49(11):1955-1958
To report the case of a child with short absences and occasional myoclonias since infancy who was first diagnosed with an idiopathic generalized epilepsy, but was documented at follow-up to have a mild phenotype of glucose transporter type 1 deficiency syndrome. Unlike other reported cases of Glut-1 DS and epilepsy, this child had a normal development as well as a normal head growth and neurological examination. Early onset of seizures and later recognized episodes of mild confusion before meals together with persistent atypical EEG features and unexpected learning difficulties led to the diagnosis. Seizure control and neuropsychological improvements were obtained with a ketogenic diet. 相似文献
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P. Parisi M. P. Villa A. Pelliccia† V. C. Rollo F. Chiarelli A. Verrotti 《Neurological sciences》2007,28(2):72-79
Abstract Panayiotopoulos syndrome is a relatively frequent and benign epileptic syndrome, characterised by predominantly autonomic
symptoms and/or simple motor focal seizures followed or not by impairment of consciousness. Interictal EEG shows occipital
spikes although multifocal spikes with high amplitude sharp-slow wave complexes at various locations can be present. This
syndrome can imitate gastroenteritis, encephalitis, syncope, migraine, sleep disorders or metabolic diseases. The peculiar
aspects should be known not only by epileptologists but also by general doctors because a correct diagnosis would avoid aggressive
interventions and concerns on account of its benign outcome. This review focuses on the main clinical and EEG features of
this epilepsy underlining its typical and atypical symptoms and its management. 相似文献
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Acosta MT Munashinge J Zhang L Guerron DA Vortmeyer A Theodore WH 《Acta neurologica Scandinavica》2012,125(1):30-37
Acosta MT, Munashinge J, Zhang L, Guerron DA, Vortmeyer A, Theodore WH. Isolated seizures in rats do not cause neuronal injury.
Acta Neurol Scand: 2012: 125: 30–37.
Published 2011. This article is a US Government work and is in the public domain in the USA. Background – Previous studies have shown that status epilepticus can lead to neuronal injury. However, the effect of a small number of isolated seizures is uncertain. Methods – We used structural MRI and neuropathology to study the effects of isolated seizures induced by kainic acid (KA), (RS)‐2‐amino‐3‐(3‐hydroxy‐5‐tert‐butylisoxazole‐4‐yl)propanoic acid (ATPA), and α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate in rats. A group of animals received normal saline. After seizure induction, animals were followed for 12 weeks. Results – ATPA and KA led to small but significant increases in ADC. There were no changes in T2 signal intensity or hippocampal volume. Blinded pathological examination showed no differences between animals receiving saline or glutamatergic agents. Conclusion – Our study suggests that isolated seizures cause minimal neuronal injury in rats. 相似文献
Acta Neurol Scand: 2012: 125: 30–37.
Published 2011. This article is a US Government work and is in the public domain in the USA. Background – Previous studies have shown that status epilepticus can lead to neuronal injury. However, the effect of a small number of isolated seizures is uncertain. Methods – We used structural MRI and neuropathology to study the effects of isolated seizures induced by kainic acid (KA), (RS)‐2‐amino‐3‐(3‐hydroxy‐5‐tert‐butylisoxazole‐4‐yl)propanoic acid (ATPA), and α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate in rats. A group of animals received normal saline. After seizure induction, animals were followed for 12 weeks. Results – ATPA and KA led to small but significant increases in ADC. There were no changes in T2 signal intensity or hippocampal volume. Blinded pathological examination showed no differences between animals receiving saline or glutamatergic agents. Conclusion – Our study suggests that isolated seizures cause minimal neuronal injury in rats. 相似文献
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E. Düzel J. Kaufmann S. Guderian A. Szentkuti B. Schott N. Bodammer M. Hopf M. Kanowski C. Tempelmann H. J. Heinze 《European journal of neurology》2004,11(3):195-205
We assessed whether interictal measures of hippocampal volume, hippocampal diffusion and metabolic abnormalities yield correlated or complementary information about hippocampal pathology in patients with temporal lobe epilepsy (TLE). Volumes, apparent diffusion coefficients (ADC) and ratios of N-acetyl-aspartate (NAA) to Creatine/Phosphocreatine (Cr) and Choline (Cho) were measured from each hippocampus during one magnetic resonance imaging (MRI) session in patients with TLE. Structural MRI showed unilateral hippocampal sclerosis (HS) in 13 patients and was normal in the remaining nine patients. Pearson's correlation (two-tailed) between ADC values and NAA/(Cr + Cho) ratios was significant (P = 0.04, r = -0.45) for the hippocampus ipsilateral to the epileptogenic zone as determined on the basis of interictal and ictal scalp EEG recordings. This finding was driven by a very high correlation between the two measures in the presence of HS (P < 0.001, r = -0.96). Furthermore, ipsilateral ADC values but not NAA/(Cr + Cho) ratios were correlated with disease duration (P = 0.001, r = 0.67). Hippocampal volumes did not correlate with either ADC values, NAA/(Cr + Cho) ratios or disease duration. These data suggest that hippocampal volumes, NAA/(Cr + Cho) ratios and ADC values capture partially complementary aspects of hippocampal pathology. 相似文献
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异丙酚对癫痫病人脑电图的影响 总被引：5，自引：0，他引：5
本文总结了15例癫痫和15例其他疾病患者在手术中用异丙酚诱导麻醉时的脑电图（EEG）特点，并将其相比较，结果发现：①异丙酚对EEG的影响主要是使α波的数量减少，β波的数量增多，且增多在各脑区的顺予是：额、颞、顶、枕，并可使两波的波幅增高，而对δ波和θ波的影响不明显，两组间也无差异；②小剂量异丙酚可诱发各组病人EEG中棘波的出现，但随着药量的增加，棘波却逐渐消失。③异丙酚诱发EEG中棘波出现的部位均为额后部，与术前EEG中有棘波出现的部位不一致，并可引起临床发作，因此，在用此药时，为了避免大脑皮层的兴奋性过高，诱发癫痫，最好采用一次大剂量静脉推入，以尽量缩短药物对大脑皮层的兴奋时间。 相似文献
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Long-Term Prognosis of the Lennox-Gastaut Syndrome 总被引：1，自引：0，他引：1
Yoko Ohtsuka M.D. Rumi Amano M.D. Michiko Mizukawa M.D. Shunsuke Ohtahara M.D. 《Psychiatry and clinical neurosciences》1990,44(2):257-264
Abstract: A long-term follow-up study of 89 patients of Lennox-Gastaut syndrome (LGS) disclosed the persistent occurrence of seizures in 68 patients (76.4%) and severe mental defect in 48 (53.9%). An analysis of the correlation between the mental and seizure prognoses confirmed that the persistence of minor seizures could result in mental deterioration. An examination of the evolutional changes in EEG demonstrated that diffuse slow spike-waves characteristic of LGS gradually disappeared, while focal epileptic discharges, especially multifocal spikes, appeared in spite of the persistence of minor seizures. The diagnostic criteria were satisfied in only 31 (47.0%) of 66 patients with the persistence of minor seizures. Patients with multiple independent spike foci and minor seizures were considered to belong to a specific type of epilepsy, namely the severe epilepsy with multiple independent spike foci (the severe epilepsy with MISF). The seizure and mental prognoses were poorer in patients who evolved into the severe epilepsy with MISF than others. 相似文献
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