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Relationship between cortex and pulvinar abnormalities on diffusion-weighted imaging in status epilepticus.

Abstract：

:The aim of this study was to analyze the pattern of magnetic resonance diffusion-weighted imaging (DWI) findings in status epilepticus in terms of clinical characteristics. Participants comprised 106 patients with status epilepticus who were admitted to our hospital and underwent DWI. Forty-five patients (42.5 %) showed abnormal findings on DWI and were divided into two groups, comprising 26 patients (24.5 %) with cortex lesions alone and 19 patients (17.9 %) with cortex and pulvinar lesions in the same hemisphere. A long duration of status epilepticus (>120 min) tended to be more prevalent among patients with cortex and pulvinar lesions (57.9 %) than among patients with cortex lesions alone (30.8 %) by univariate and multivariate analyses. Todd's palsy tended to be more frequent in patients with abnormalities on DWI (24/45, 53.3 %) than in patients with normal DWI (21/61, 34.4 %). Six of the 26 patients with cortex lesions alone (23.1 %) had taken anti-epileptic drugs before the attack compared to none of the 19 patients with both cortex and pulvinar lesions. The trend toward a longer duration of status epilepticus in patients with both cortex and pulvinar lesions favors a spreading pattern of seizure discharge from cortex to pulvinar via cortico-pulvinar pathways, and anti-epileptic drugs might, to some extent, prevent spreading of seizure discharge from cortex to pulvinar. In addition, existence of high-intensity areas on DWI at the onset of epilepsy may be a predictive factor for the occurrence of Todd's palsy.

journal_name

J Neurol

journal_title

Journal of neurology

authors

Nakae Y,Kudo Y,Yamamoto R,Dobashi Y,Kawabata Y,Ikeda S,Yokoyama M,Higashiyama Y,Doi H,Johkura K,Tanaka F

doi

10.1007/s00415-015-7948-4

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

127-32

issue

1

eissn

0340-5354

issn

1432-1459

pii

10.1007/s00415-015-7948-4

journal_volume

263

pub_type

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