Epileptic foci and networks in children with epilepsy after acute encephalopathy with biphasic seizures and late reduced diffusion

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2024-08-01 DOI:10.1016/j.braindev.2024.07.003

Takamasa Mitsumatsu , Yuji Ito , Yuki Maki , Hiroyuki Yamamoto , Fumi Sawamura , Tomotaka Ishizaki , Satoshi Maesawa , Epifanio Bagarinao , Tomohiko Nakata , Hiroyuki Kidokoro , Ryuta Saito , Jun Natsume

{"title":"Epileptic foci and networks in children with epilepsy after acute encephalopathy with biphasic seizures and late reduced diffusion","authors":"Takamasa Mitsumatsu , Yuji Ito , Yuki Maki , Hiroyuki Yamamoto , Fumi Sawamura , Tomotaka Ishizaki , Satoshi Maesawa , Epifanio Bagarinao , Tomohiko Nakata , Hiroyuki Kidokoro , Ryuta Saito , Jun Natsume","doi":"10.1016/j.braindev.2024.07.003","DOIUrl":null,"url":null,"abstract":"<div>Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) develops along with status epilepticus and widespread subcortical white matter edema. We aimed to evaluate the epileptic foci and networks in two patients with epilepsy after AESD using simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI). Methods: Statistically significant blood oxygen level-dependent (BOLD) responses related to interictal epileptiform discharges (IEDs) were analyzed using an event-related design of hemodynamic response functions with multiple peaks. Results: Patient 1 developed focal seizures at age 10 years, one year after AESD onset. Positive BOLD changes were observed in the bilateral frontotemporal lobes, left parietal lobe, and left insula. BOLD changes were also observed in the subcortical structures. Patient 2 developed epileptic spasms at age two years, one month after AESD onset. Following total corpus callosotomy (CC) at age three years, the epileptic spasms resolved, and neurodevelopmental improvement was observed. Before CC, positive BOLD changes were observed bilaterally in the frontotemporal lobes. BOLD changes were also observed in the subcortical structures. After CC, the positive BOLD changes were localized in the temporal lobe ipsilateral to the IEDs, and the negative BOLD changes were mainly in the cortex and subcortical structures of the hemisphere ipsilateral to IEDs. Conclusion: EEG-fMRI revealed multiple epileptic foci and extensive epileptic networks, including subcortical structures in two cases with post-AESD epilepsy. CC may be effective in disconnecting the bilaterally synchronous epileptic networks of epileptic spasms after AESD, and pre-and post-operative changes in EEG-fMRI may reflect improvements in epileptic symptoms.</div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain & Development","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0387760424000986","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) develops along with status epilepticus and widespread subcortical white matter edema. We aimed to evaluate the epileptic foci and networks in two patients with epilepsy after AESD using simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI). Methods: Statistically significant blood oxygen level-dependent (BOLD) responses related to interictal epileptiform discharges (IEDs) were analyzed using an event-related design of hemodynamic response functions with multiple peaks. Results: Patient 1 developed focal seizures at age 10 years, one year after AESD onset. Positive BOLD changes were observed in the bilateral frontotemporal lobes, left parietal lobe, and left insula. BOLD changes were also observed in the subcortical structures. Patient 2 developed epileptic spasms at age two years, one month after AESD onset. Following total corpus callosotomy (CC) at age three years, the epileptic spasms resolved, and neurodevelopmental improvement was observed. Before CC, positive BOLD changes were observed bilaterally in the frontotemporal lobes. BOLD changes were also observed in the subcortical structures. After CC, the positive BOLD changes were localized in the temporal lobe ipsilateral to the IEDs, and the negative BOLD changes were mainly in the cortex and subcortical structures of the hemisphere ipsilateral to IEDs. Conclusion: EEG-fMRI revealed multiple epileptic foci and extensive epileptic networks, including subcortical structures in two cases with post-AESD epilepsy. CC may be effective in disconnecting the bilaterally synchronous epileptic networks of epileptic spasms after AESD, and pre-and post-operative changes in EEG-fMRI may reflect improvements in epileptic symptoms.

查看原文本刊更多论文

伴有双相癫痫发作和晚期弥散功能减退的急性脑病后癫痫患儿的癫痫灶和网络。

背景：急性脑病伴有双相癫痫发作和晚期弥散减少（AESD），同时伴有癫痫状态和广泛的皮层下白质水肿。我们的目的是利用同步脑电图和功能磁共振成像（EEG-fMRI）评估两名 AESD 后癫痫患者的癫痫灶和网络：方法：采用多峰血流动力学响应函数的事件相关设计，分析与发作间期癫痫样放电（IED）相关的具有统计学意义的血氧水平依赖性（BOLD）响应：患者1在AESD发病一年后，于10岁时出现局灶性癫痫发作。在双侧额颞叶、左顶叶和左侧岛叶观察到阳性 BOLD 变化。皮层下结构也出现了 BOLD 变化。患者 2 在两岁时，即 AESD 发病一个月后出现癫痫痉挛。三岁时进行胼胝体全切除术（CC）后，癫痫痉挛缓解，神经发育也有所改善。在进行胼胝体切开术之前，双侧额颞叶观察到 BOLD 阳性变化。皮层下结构也出现了 BOLD 变化。CC 后，BOLD 阳性变化位于 IEDs 同侧的颞叶，BOLD 阴性变化主要位于 IEDs 同侧半球的皮层和皮层下结构：结论：EEG-fMRI显示两例AESD后癫痫患者存在多个癫痫灶和广泛的癫痫网络，包括皮层下结构。CC可有效断开AESD后癫痫痉挛的双侧同步癫痫网络，术前术后脑电图-磁共振成像的变化可反映癫痫症状的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.