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Frontal hemodynamic changes precede EEG onset of temporal lobe seizures
Institution:1. Ochsner Clinic Foundation, Department of Neurosurgery, New Orleans, LA, USA;2. Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA;3. Ochsner Clinic Foundation, Department of Movement Disorders, New Orleans, LA, USA;1. Département de génie électrique, École Polytechnique de Montréal, C.P. 6079, Succ. Centre-ville, Montréal, QC, Canada H3C3A7;2. Service de neurologie, Hôpital Notre-Dame du CHUM, 1560 Rue Sherbrooke Est, Montréal, QC, Canada H3L4M1;3. Centre de recherche, Hôpital Sainte-Justine, 3175 Chemin de la côte-Sainte-Catherine, Montréal, QC, Canada H3T1C5;4. Centre de recherche en neuropsychologie et cognition, Département de psychologie, Université de Montréal, Montréal, QC, Canada H3C3J7;5. Institut de cardiologie de Montréal, Centre de recherche, 5000 Rue Bélanger Est, Montréal, QC, Canada H1T1C8;2. Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russian Federation;3. Department of Clinical Medicine (Anesthesiology), Faculty of Health Sciences, University of Tromsoe, Tromsoe, Norway;1. Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA;2. Pediatric Neurology Unit, Department of Pediatrics, Hospital Universitari Son Espases, Universitat de les Illes Balears, Palma, Spain;3. Department of Neurology, National Children’s Hospital “Dr. Carlos Saenz Herrera”, San José, Costa Rica;1. Department of Neurology 2, Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris (AP-HP), 75013, Paris, France;2. Sorbonne Universités, Université Pierre et Marie Curie, Université Paris VI, 75013, Paris, France;3. Institut du Cerveau et de la Moelle Epinière, INSERM U1127 and Centre National de la Recherche Scientifique, Unité de Recherche Mixte, 7225, Paris, France;4. Deparment of Clinical Neurophysiology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris (AP-HP), 75013, Paris, France;5. Department of Neuro-radiology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris (AP-HP), 75013, Paris, France;6. Otolaryngology – Head and Neck Surgery Department, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris (AP-HP), 75475, Paris, France;7. Neuro-Ophthalmology Unit, Lyon Civil Hospitals, Neurological Hospital, Lyon 1 University, Bron Cedex, France
Abstract:ObjectiveA preictal state exists minutes or hours prior to the clinical seizure. We investigated whether hemodynamic changes preceding temporal lobe seizures were detectable in frontal scalp recordings using near-infrared spectroscopy (NIRS). Patients undergoing video-EEG telemetry (VET) were studied.MethodsA NIRS sensor was placed over the frontal scalp ipsilateral to the patient’s first recorded seizure. Regional cerebral oxygenation (rSO2) was recorded synchronously with VET data and peripheral oxygen saturation (SaO2). Periictal changes in rSO2 were compared with baseline interictal rSO2.ResultsEleven seizures were recorded in six patients. A mean peak preictal increase in rSO2 of 7.1% from the interictal baseline (p < 0.001) occurred at a mean peak latency of 298.9 s before seizure onset. rSO2 then decreased around seizure onset. SaO2 nadir occurred at a mean latency of 62 s following rSO2 nadir. A postictal increase in rSO2 occurred with a mean duration of about 35 min. Periictal rSO2 changes occurred with both ipsi and contralateral temporal lobe seizures.ConclusionWe have shown that preictal changes in cerebral oxygenation occur with a mean peak latency of about 4.98 min before seizure onset.SignificanceNIRS has the potential for providing a noninvasively detected signal of an imminent seizure.
Keywords:Preictal  Cerebral oxygenation  Near-infrared spectroscopy  Seizure
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