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Epileptic spikes in Rasmussen's encephalitis: Migratory pattern and short-term evolution. A MEG study
Davide Rossi Sebastiano1, Elisa Visani1, Dunja Duran1
1Neurophysiopathology Department and Epilepsy Centre, IRCCS Foundation, Milan, Italy.
Objective:
We aimed this study at identifying cortical areas involved in the generation of interictal spikes in Rasmussen's Encephalitis (RE) patients using magnetoencephalography (MEG), at comparing spike localization with the degree of cortical atrophy detected by MRI, and at identifying short-term changes during the follow-up.
Methods:
Five patients with RE underwent two MEG and magnetic resonance imaging (MRI) (six months interval). The sources of visually detected spikes were estimated using equivalent current dipoles technique; these were then superimposed on individual MRI and clustered; the locations of the clusters were related to the MRI stage of cortical atrophy.
Results:
All patients showed spikes and clusters located in different cortical areas in both recordings; the locations had a limited correspondence with cortical atrophy. The second recordings showed changes in the localisation of spikes and clusters, and confirmed the dissimilarities with neuroradiological abnormalities.
Conclusions:
The presence of clusters of spikes of variable localisation suggests that RE progresses in a multifocal and fluctuating manner. The cortical areas most involved in epileptogenesis did not completely coincide with the most atrophic areas.
Significance:
MEG can contribute to evaluating multifocal hemispheric spikes in RE and to better understand the time course of epileptogenic process.
Insights
Magnetoencephalography (MEG) reveals that Rasmussen's Encephalitis (RE) involves multifocal, fluctuating cortical areas for spike generation, which do not fully align with MRI-detected atrophy.
Area of Science:
- Neuroscience
- Epileptology
- Medical Imaging
Background:
- Rasmussen's Encephalitis (RE) is a rare neurological disorder characterized by progressive inflammation and neuronal loss.
- Understanding the precise cortical regions involved in epileptogenesis is crucial for managing RE.
Purpose of the Study:
- To identify cortical areas generating interictal spikes in RE patients using MEG.
- To compare spike localization with MRI-detected cortical atrophy.
- To track short-term changes in spike localization during follow-up.
Main Methods:
- Five RE patients underwent two MEG and MRI sessions six months apart.
- Equivalent current dipole technique estimated spike sources.
- Spike cluster locations were superimposed on MRI and correlated with atrophy.
Main Results:
- Spikes and clusters were identified in diverse cortical areas across both recordings.
- Spike localization showed limited correlation with cortical atrophy.
- Changes in spike and cluster localization were observed between recordings, differing from neuroradiological findings.
Conclusions:
- RE exhibits multifocal and fluctuating progression, indicated by variable spike cluster localization.
- Epileptogenic cortical areas do not entirely overlap with the most atrophic regions.
- MEG aids in assessing multifocal hemispheric spikes and understanding the temporal dynamics of epileptogenesis in RE.
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