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Cerebral perfusion-CT patterns following seizure.
J M Gelfand1, M Wintermark, S A Josephson
1Department of Neurology, Neuroradiology Section, University of California, San Francisco, CA 94143-0114, USA.
European Journal of Neurology
|December 9, 2009
Summary
Post-ictal cerebral perfusion-CT (PCT) abnormalities are common in patients shortly after seizure. Imaging within 2 hours of seizure termination increases the likelihood of detecting these perfusion changes.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cerebral perfusion-CT (PCT) is a standard tool for stroke assessment.
- PCT may also reveal abnormalities after seizures.
Purpose of the Study:
- To investigate the utility of PCT in detecting post-ictal abnormalities.
- To compare PCT findings in patients with normal vs. abnormal post-ictal scans.
Main Methods:
- Retrospective analysis of 27 patients with seizure-related neurological deficits.
- PCT imaging performed within 72 hours of seizure.
- Exclusion of patients with seizures secondary to acute processes.
Main Results:
- 37% of patients showed abnormal post-ictal PCT.
- Focal hypoperfusion was the most common abnormality (8/10 patients).
- Abnormalities were more likely when imaging occurred within 2 hours of seizure.
Conclusions:
- Post-ictal PCT abnormalities are frequent in the early period after seizure.
- Atypical perfusion patterns on PCT, without large vessel occlusion on CTA, suggest seizure as a diagnosis.
- Consider seizure in differential diagnosis before acute stroke therapy when PCT findings are unusual.
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