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Published on: August 5, 2014
Ictal brain hemodynamics in the epileptic focus caused by a brain tumor using functional magnetic resonance imaging
1Department of Neuropsychiatry, Graduate School of Medical Science, Gunma University, 39-15, Showa-machi 3-Chome, Maebashi-shi, Gunma, 371-8511, Japan. kubota@showa.gunma-u.ac.jp
Abstract:
Using functional magnetic resonance imaging (fMRI) we were able to observe, in detail, ictal brain hemodynamics during epileptic seizure caused by a brain tumor. A 53-year-old man was experencing partial motor seizures of the left side of his face and neck. In a brain MR image a mass lesion was found in the subcortical area of the right frontal lobe. We found focal spikes in his right hemisphere, though dominantly in C4 and T4 regions. fMRI investigations were carried out at 1.5 T (GE Signa Horizon) using gradient-echo echo-planar neuroimaging. We were able to perform the ictal examination twice. The activated regions were focalized and clearly found only on the lateral side of the tumor base. The region was in agreement with the epileptic focus examined using an electrocorticogram (ECOG). The signal intensity in the seizure focus rapidly increased 30 seconds before the convulsion was observed. After the end of the convulsion it also took 30 seconds to restore the signal intensity to the baseline value. fMRI is a very useful tool for various studies such as the identification of the epileptic focus, the mechanism of epileptic seizure, and so on.
Insights
Functional magnetic resonance imaging (fMRI) precisely mapped brain blood flow changes during epileptic seizures caused by a brain tumor. This technique effectively identified the seizure focus, aiding in understanding epilepsy mechanisms.
Area of Science:
- Neuroimaging
- Epileptology
- Neurosurgery
Background:
- Epileptic seizures can be caused by brain tumors, necessitating precise localization for effective treatment.
- Understanding the ictal hemodynamics (blood flow changes during a seizure) is crucial for identifying the seizure's origin.
Observation:
- A 53-year-old male patient experienced partial motor seizures originating from the right frontal lobe tumor.
- Functional magnetic resonance imaging (fMRI) was used to observe brain activity during seizures.
- Electrodes placed during an electrocorticogram (ECOG) confirmed the seizure focus identified by fMRI.
Findings:
- fMRI revealed focal brain activation at the base of the tumor during seizures.
- Signal intensity changes in the seizure focus occurred 30 seconds before and after observed convulsions.
- The identified seizure focus correlated with electrocorticogram findings.
Implications:
- fMRI is a valuable tool for precisely identifying epileptic foci, especially those associated with brain tumors.
- Detailed ictal hemodynamic mapping can enhance the understanding of seizure generation and propagation.
- This approach can guide surgical planning and improve patient outcomes in epilepsy treatment.
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