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Related Concept Videos

Seizures: Classification01:13

Seizures: Classification

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
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Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
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Relationship between cortex and pulvinar abnormalities on diffusion-weighted imaging in status epilepticus.

Yoshiharu Nakae1,2, Yosuke Kudo2, Ryoo Yamamoto2

  • 1Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.

Journal of Neurology
|November 5, 2015
PubMed
Summary

Magnetic resonance diffusion-weighted imaging (DWI) reveals distinct patterns in status epilepticus. Abnormal DWI findings, particularly cortex and pulvinar lesions, correlate with longer seizures and Todd's palsy, suggesting seizure spread.

Keywords:
Anti-epileptic drugsCortico-pulvinar pathwayDiffusion-weighted imagingDuration of status epilepticusStatus epilepticusTodd’s palsy

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Status epilepticus (SE) is a neurological emergency characterized by prolonged seizures.
  • Magnetic resonance imaging (MRI), particularly diffusion-weighted imaging (DWI), plays a crucial role in diagnosing SE and understanding its underlying pathophysiology.
  • Understanding the patterns of DWI findings in SE can provide insights into clinical characteristics and potential outcomes.

Purpose of the Study:

  • To analyze the patterns of magnetic resonance diffusion-weighted imaging (DWI) findings in status epilepticus (SE).
  • To correlate DWI findings with clinical characteristics of patients experiencing SE.
  • To investigate the relationship between DWI abnormalities, seizure duration, and neurological deficits like Todd's palsy.

Main Methods:

  • Retrospective analysis of 106 patients with SE who underwent DWI.
  • Classification of abnormal DWI findings into cortex lesions alone and cortex and pulvinar lesions.
  • Statistical analysis (univariate and multivariate) to compare clinical characteristics between DWI groups.

Main Results:

  • 42.5% of SE patients showed abnormal DWI findings.
  • Patients with cortex and pulvinar lesions had a higher prevalence of prolonged SE duration (>120 min) compared to those with cortex lesions alone.
  • Abnormal DWI findings were associated with a higher incidence of Todd's palsy, and anti-epileptic drug use might mitigate seizure spread.

Conclusions:

  • DWI patterns in SE can indicate seizure spread, particularly from the cortex to the pulvinar.
  • Prolonged SE duration and the presence of cortex and pulvinar lesions on DWI are associated with increased risk of Todd's palsy.
  • DWI findings at epilepsy onset may predict the occurrence of Todd's palsy, and anti-epileptic drugs may influence seizure spread patterns.