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Perfusion-CT imaging in epileptic seizures.
Davide Strambo1,2, V Rey3, A O Rossetti3
1Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. strambodavide@gmail.com.
Journal of Neurology
|October 18, 2018
Summary
Perfusion CT (PCT) abnormalities can indicate seizures or stroke in acute neurological syndromes. Hyperperfusion suggests seizures, while hypoperfusion may be post-ictal or indicate stroke.
Area of Science:
- Neurology
- Neuroradiology
- Epileptology
Background:
- Perfusion CT (PCT) is crucial for diagnosing acute neurological conditions like stroke.
- This study investigates PCT abnormalities in patients presenting with acute epileptic seizures or status epilepticus (SE).
Observation:
- 43 patients with suspected acute ischemic stroke (AIS) were diagnosed with focal or generalized seizures.
- PCT scans were analyzed for hyperperfusion and hypoperfusion, correlating with seizure characteristics and outcomes.
Findings:
- Regional PCT abnormalities were found in half of the patients.
- Hyperperfusion (30%) was linked to ongoing or recent seizures/SE, while hypoperfusion (19%) suggested post-ictal states or concurrent AIS.
- 4% of patients had AIS, with hypoperfusion being a potential indicator.
Implications:
- PCT findings can help differentiate between epileptic seizures and stroke in acute neurological presentations.
- Identifying seizure-related perfusion changes aids in accurate diagnosis and targeted treatment, potentially avoiding misdiagnosis of stroke.
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