Yıl: 2021 Cilt: 27 Sayı: 1 Sayfa Aralığı: 15 - 22 Metin Dili: İngilizce DOI: 10.14744/epilepsi.2020.40469 İndeks Tarihi: 05-06-2021

Transient Imaging Findings Related to Status Epilepticus

Öz:
Objectives: We aim to draw attention to transient imaging findings related to epileptic seizures, which is a rare condition that is often over-looked and may even lead to misdiagnosis.Methods:Records of 106 patients with seizures were reviewed and patients with transient magnetic resonance imaging (MRI) findings were detected. Seizure type and transient imaging findings (TIF) features were analyzed retrospectively.Results:Status epilepticus (SE) was found in 45 of the 106 patients who had epileptic seizures, and 9 of them had TIF. The average age of the patients was 52.9 years (28–78). The first seizure was a SE in eight (89%) patients. Three (33.3%) had a focal SE, four (44.4%) had a generalized tonic-clonic SE, whereas two (22.2%) evolved from a focal seizure to a bilateral tonic-clonic seizure. All patients with focal features had a sei-zure semiology that was compatible with the TIF side. In cranial MRI, cortical changes were detected in six, thalamic changes in one, cortical and thalamic changes in one, and leptomeningeal enhancements in one patient. These changes returned to normal in all patients within two weeks. Two patients died due to non-SE causes, whereas other patients resumed their daily routines.Conclusion:MRI findings after SE are rare but if detected, are an important indicator with localization and lateralization values, contributing to the semiological findings and localization. It is often confused with conditions that are its differential diagnosis. Knowing the MRI changes associated with SE is important to avoid misdiagnosis, understand its pathophysiology, and determine the prognosis.
Anahtar Kelime:

Status Epileptikus ile İlişkili Geçici Görüntüleme Bulguları

Öz:
Amaç: Bu çalışmanın amacı, çoğunlukla gözden kaçan ve hatta yanlış tanıya neden olabilecek nadir bir durum olan epilepsi nöbetlerine bağlı geçici görüntüleme bulgularına dikkat çekmektir.Gereç ve Yöntem: Çalışmada nöbet geçiren 106 hastanın kayıtları gözden geçirilmiş ve geçici manyetik rezonans görüntüleme bulguları olan hastalar saptanmıştır. Nöbet tipi ve geçici görüntüleme bulgularının özellikleri retrospektif olarak incelenmiştir.Bulgular: Epilepsi nöbeti geçiren 106 hastanın 45’inde status epileptikus, dokuzunda geçici görüntüleme bulguları saptanmıştır. Ortalama yaş 52.9 (28-78 yıl) yıl olarak tespit edilmiştir. Hastaların sekizinde (%89) ilk nöbet status epileptikus olmuştur. Üçünde (%33.3) fokal status epilep-tikus, dördünde (%44.4) fokal nöbetten bilateral tonik-klonik nöbete evrilen status epileptikus, ikisinde (%22.2) jeneralize tonik-klonik status epileptikus saptanmıştır. Fokal özellik gösteren nöbetleri olan hastaların tamamında nöbet semiyolojisi ile geçici görüntüleme bulguları tarafı uyumlu bulunmuştur. Kraniyal manyetik rezonans görüntülemede altısında kortikal değişiklik, birinde talamik değişiklik, birinde kortikal ve ta-lamik değişiklik, birinde de leptomeningeal kontrastlanma saptanmıştır. Bu değişiklikler tüm hastalarda iki hafta içinde eski haline dönmüştür. İki hasta status epileptikus dışı nedenlerle kaybedilmiş, diğer hastalar günlük yaşamlarına geri dönmüşlerdir.Sonuç: Status epileptikus sonrası manyetik rezonans görüntüleme bulguları nadir görülen ancak saptanırsa lokalizasyon ve lateralizasyon de-ğeri olan, semiyolojik bulgulara ve lokalizasyona katkısı olan önemli bir göstergedir. Genellikle ayırıcı tanıya giren durumlarla karıştırılır. Status epileptikus ile manyetik rezonans görüntülemedeki değişikliklerin bilinmesi yanlış tanıdan kaçınmak, patofizyolojiyi anlamak ve prognozu belirlemek açısından önemlidir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Hopkins A, Shorvon S, Cascino G. Epilepsy. London: Chapman and Hall; 1995. p. 331–50.
  • 2. Akpınar ÇK, Cengiz N. Current Diagnosis, Treatment and Etiology of Status Epilepticus. Epilepsi 2014;20(1):1–10.
  • 3. Leitinger M, Trinka E, Giovannini G, Zimmermann G, Florea C, Rohracher A, et al. Epidemiology of status epilepticus in adults: A population-based study on incidence, causes, and outcomes. Epilepsia 2019;60(1):53–62.
  • 4. Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al; Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012;17(1):3–23.
  • 5. Horsley V. An Address on the Origin and Seat of Epileptic Disturbance: Delivered before the Cardiff Medical Society. Br Med J 1892;1(1631):693–6.
  • 6. Rumack CM, Guggenheim MA, Fasules JW, Burdick D. Transient positive postictal computed tomographic scan. J Pediatr 1980;97(2):263–4.
  • 7. Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, Shorvon S, Lowenstein DH. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015;56(10):1515–23.
  • 8. Fisher RS, Cross JH, D’Souza C, French JA, Haut SR, Higurashi N, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia 2017;58(4):531–42.
  • 9. Riviello JJ Jr, Ashwal S, Hirtz D, Glauser T, Ballaban-Gil K, Kelley K, et al. Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2006;67(9):1542–50.
  • 10. Lyons TW, Johnson KB, Michelson KA, Nigrovic LE, Loddenkemper T, Prabhu SP, et al. Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus. Seizure 2016;35:4–10.
  • 11. Milligan TA, Zamani A, Bromfield E. Frequency and patterns of MRI abnormalities due to status epilepticus. Seizure 2009;18(2):104-8.
  • 12. Kim JA, Chung JI, Yoon PH, Kim DI, Chung TS, Kim EJ, et al. Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. AJNR Am J Neuroradiol 2001;22(6):1149–60.
  • 13. Lansberg MG, O’Brien MW, Norbash AM, Moseley ME, Morrell M, Albers GW. MRI abnormalities associated with partial status epilepticus. Neurology 1999;52(5):1021–7.
  • 14. Diehl B, Najm I, Ruggieri P, Tkach J, Mohamed A, Morris H, et al. Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy. Epilepsia 2001;42(1):21–8.
  • 15. Vollmar C, Noachtar S. Neuroimaging in Epilepsy. Türk Nöroloji Dergisi 2004;10(3):185–200.
  • 16. Meletti S, Monti G, Mirandola L, Vaudano AE, Giovannini G. Neuroimaging of status epilepticus. Epilepsia 2018;59(Suppl 2):113–9.
  • 17. Samaniego EA, Stuckert E, Fischbein N, Wijman CA. Crossed cerebellar diaschisis in status epilepticus. Neurocrit Care 2010;12(1):88–90.
  • 18. Friedman E. Epilepsy imaging in adults: getting it right. AJR Am J Roentgenol 2014;203(5):1093–103.
  • 19. Hong KS, Cho YJ, Lee SK, Jeong SW, Kim WK, Oh EJ. Diffusion changes suggesting predominant vasogenic oedema during partial status epilepticus. Seizure 2004;13(5):317–21.
  • 20. Meletti S, Giovannini G, d’Orsi G, Toran L, Monti G, Guha R, et al. New-Onset Refractory Status Epilepticus with Claustrum Damage: Definition of the Clinical and Neuroimaging Features. Front Neurol 2017;8:111.
  • 21. Choy M, Cheung KK, Thomas DL, Gadian DG, Lythgoe MF, Scott RC. Quantitative MRI predicts status epilepticus-induced hippocampal injury in the lithium-pilocarpine rat model. Epilepsy Res 2010;88(2-3):221–30.
  • 22. Guerriero RM, Gaillard WD. Imaging modalities to diagnose and localize status epilepticus. Seizure 2019;68:46–51.22
  • 23. Nakae Y, Kudo Y, Yamamoto R, Dobashi Y, Kawabata Y, Ikeda S, et al. Relationship between cortex and pulvinar abnormalities on diffusion-weighted imaging in status epilepticus. J Neurol 2016;263(1):127–32.
  • 24. Ohe Y, Hayashi T, Deguchi I, Fukuoka T, Horiuchi Y, Maruyama H, et al. MRI abnormality of the pulvinar in patients with status epilepticus. J Neuroradiol 2014;41(4):220–6.
  • 25. Mendes A, Sampaio L. Brain magnetic resonance in status epilepticus: A focused review. Seizure 2016;38:63–7.
  • 26. Aellen J, Abela E, Buerki SE, Kottke R, Springer E, Schindler K, et al. Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI). Eur Radiol 2014;24(11):2980–8.
  • 27. Lazeyras F, Blanke O, Zimine I, Delavelle J, Perrig SH, Seeck M. MRI, (1)H-MRS, and functional MRI during and after prolonged nonconvulsive seizure activity. Neurology 2000;55(11):1677–82.
  • 28. Kutluay E, Beattie J, Passaro EA, Edwards JC, Minecan D, Milling C, et al. Diagnostic and localizing value of ictal SPECT in patients with nonconvulsive status epilepticus. Epilepsy Behav 2005;6(2):212–7.
  • 29. Doherty CP, Cole AJ, Grant PE, Fischman A, Dooling E, Hoch DB, et al. Multimodal longitudinal imaging of focal status epilepticus. Can J Neurol Sci 2004;31(2):276–81.
  • 30. Tenney JR, Marshall PC, King JA, Ferris CF. fMRI of generalized absence status epilepticus in conscious marmoset monkeys reveals corticothalamic activation. Epilepsia 2004;45(10):1240–7
APA Ilgen Uslu F, Bebek N (2021). Transient Imaging Findings Related to Status Epilepticus. , 15 - 22. 10.14744/epilepsi.2020.40469
Chicago Ilgen Uslu Ferda,Bebek Nerses Transient Imaging Findings Related to Status Epilepticus. (2021): 15 - 22. 10.14744/epilepsi.2020.40469
MLA Ilgen Uslu Ferda,Bebek Nerses Transient Imaging Findings Related to Status Epilepticus. , 2021, ss.15 - 22. 10.14744/epilepsi.2020.40469
AMA Ilgen Uslu F,Bebek N Transient Imaging Findings Related to Status Epilepticus. . 2021; 15 - 22. 10.14744/epilepsi.2020.40469
Vancouver Ilgen Uslu F,Bebek N Transient Imaging Findings Related to Status Epilepticus. . 2021; 15 - 22. 10.14744/epilepsi.2020.40469
IEEE Ilgen Uslu F,Bebek N "Transient Imaging Findings Related to Status Epilepticus." , ss.15 - 22, 2021. 10.14744/epilepsi.2020.40469
ISNAD Ilgen Uslu, Ferda - Bebek, Nerses. "Transient Imaging Findings Related to Status Epilepticus". (2021), 15-22. https://doi.org/10.14744/epilepsi.2020.40469
APA Ilgen Uslu F, Bebek N (2021). Transient Imaging Findings Related to Status Epilepticus. Epilepsi, 27(1), 15 - 22. 10.14744/epilepsi.2020.40469
Chicago Ilgen Uslu Ferda,Bebek Nerses Transient Imaging Findings Related to Status Epilepticus. Epilepsi 27, no.1 (2021): 15 - 22. 10.14744/epilepsi.2020.40469
MLA Ilgen Uslu Ferda,Bebek Nerses Transient Imaging Findings Related to Status Epilepticus. Epilepsi, vol.27, no.1, 2021, ss.15 - 22. 10.14744/epilepsi.2020.40469
AMA Ilgen Uslu F,Bebek N Transient Imaging Findings Related to Status Epilepticus. Epilepsi. 2021; 27(1): 15 - 22. 10.14744/epilepsi.2020.40469
Vancouver Ilgen Uslu F,Bebek N Transient Imaging Findings Related to Status Epilepticus. Epilepsi. 2021; 27(1): 15 - 22. 10.14744/epilepsi.2020.40469
IEEE Ilgen Uslu F,Bebek N "Transient Imaging Findings Related to Status Epilepticus." Epilepsi, 27, ss.15 - 22, 2021. 10.14744/epilepsi.2020.40469
ISNAD Ilgen Uslu, Ferda - Bebek, Nerses. "Transient Imaging Findings Related to Status Epilepticus". Epilepsi 27/1 (2021), 15-22. https://doi.org/10.14744/epilepsi.2020.40469