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Status epilepticus and periictal imaging.
1MGH Epilepsy Service, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. cole.andrew@mgh.harvard.edu
Epilepsia
|July 30, 2004
Summary
Acute imaging findings during and after seizures, including magnetic resonance imaging and positron emission tomography, are increasingly recognized. Understanding their reversibility and relationship to seizure characteristics is crucial for clinical significance.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Peri- and postictal changes on imaging have long been observed.
- Advances in magnetic resonance imaging (MRI) and positron emission tomography (PET) have expanded the range of recognized acute findings.
- These findings can be local or remote to the seizure's electroencephalogram (EEG) abnormality site.
Purpose of the Study:
- To review described peri- and postictal imaging findings.
- To contextualize these findings within pathophysiologic mechanisms.
- To explore the clinical significance of these imaging abnormalities.
Main Methods:
- Review of existing literature on peri- and postictal imaging findings.
- Classification of findings based on location relative to EEG abnormalities.
- Analysis of potential pathophysiologic mechanisms and factors influencing reversibility.
Main Results:
- A wide spectrum of acute imaging findings during and after seizures is described.
- Findings are categorized as local or remote to the ictal EEG focus.
- Reversibility of findings is variable and incompletely understood.
Conclusions:
- Peri- and postictal imaging findings offer insights into seizure pathophysiology.
- Further research is needed to understand factors governing the resolution of these changes.
- A framework relating seizure characteristics to imaging abnormalities and pathophysiology is proposed.