Neuroimaging correlation with EEG in status epilepticus.

Area of Science:

• Neuroscience
• Radiology
• Epileptology

Background:

• Status epilepticus (SE) is a neurological emergency requiring prompt diagnosis and management.
• Understanding the relationship between electrophysiological findings and neuroimaging in SE is crucial for accurate prognostication and treatment.

Purpose of the Study:

• To investigate the correlation between electroencephalography (EEG) patterns and peri-ictal CT perfusion abnormalities (PCA) or MRI abnormalities (PMA) in patients with SE.

Main Methods:

• A retrospective study analyzed 73 SE patients (2016-2021).
• PCA was defined as cortical/thalamic hyper-perfusion; PMA as increased signal intensity in multiple brain regions.
• EEG patterns were classified into electrographic seizure (ESz)/electroclinical seizure (ECSz), ictal-interictal continuum (IIC), and lateralized periodic discharges (LPDs).

Main Results:

• 19 patients (26%) showed PCA, and 18 (25%) showed PMA.
• EEG patterns included ESz/ECSz (25%), IIC (34%), and LPD (12%).
• A significant correlation was found between EEG patterns and PMA, but not PCA.

Conclusions:

• Peri-ictal MRI abnormalities (PMA) are strongly associated with various EEG patterns in SE, including ESz, ECSz, IIC, and LPD.
• Peri-ictal CT perfusion abnormalities (PCA) did not show a significant electro-radiographical correlation in this SE cohort.