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Cerebral blood flow and temporal lobe epileptogenicity
M E Weinand1, L P Carter, W F el-Saadany
1Department of Surgery, University of Arizona College of Medicine, Tucson, USA.
Journal of Neurosurgery
|February 1, 1997
Summary
Temporal lobe epilepsy epileptogenicity is linked to cerebral blood flow (CBF) changes. Reduced CBF in the epileptic focus correlates with increased seizure frequency, suggesting vasomotor changes may trigger seizures.
Area of Science:
- Neuroscience
- Medical Imaging
Background:
- Temporal lobe epilepsy (TLE) is a common neurological disorder characterized by recurrent seizures originating in the temporal lobe.
- Understanding the underlying pathophysiology of TLE, particularly the relationship between cortical perfusion and epileptogenicity, is crucial for developing effective treatments.
Purpose of the Study:
- To investigate the hypothesis that temporal lobe epileptogenicity is a function of epileptic cortical perfusion.
- To explore the relationship between long-term cerebral blood flow (CBF) monitoring and seizure activity in patients with TLE.
Main Methods:
- Performed 43 bitemporal 2-hour periictal CBF studies in 13 patients with TLE.
- Monitored CBF using long-term surface monitoring.
- Correlated CBF data with electrocorticographic (ECoG) and clinical seizure onset.
Main Results:
- Interictal epileptic cortical hypoperfusion and nonepileptic normal cortical CBF were observed.
- A significant, sustained increase in CBF in the epileptic temporal lobe preceded seizure onset.
- CBF alterations preceded ECoG seizure activity, suggesting a role in seizure generation.
- Progressive hypoperfusion correlated with increased epileptogenicity (decreased seizure interval), while increased perfusion correlated with decreased epileptogenicity (increased seizure interval).
Conclusions:
- Temporal lobe epileptogenicity is directly correlated with epileptic cortical CBF.
- Vasomotor changes, indicated by CBF alterations, may precede and potentially trigger electrophysiological and clinical seizure onset.
- CBF monitoring offers insights into the dynamic changes associated with TLE.