Dynamic susceptibility contrast (DSC) MRI and interictal epileptiform activity in cryptogenic partial epilepsy

Fabio Placidi, Roberto Floris, Alessandro Bozzao, Andrea Romigi, Mario Tombini, Maria Elena Baviera, Francesca Sperli, Francesca Izzi, Donatella Mattia, Maria Grazia Marciani

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To study the possible correlation between interictal EEG patterns and neuroradiologic data obtained by dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) in patients with partial epilepsy. Methods: Seventeen subjects with cryptogenic partial epilepsy underwent long-term video-EEG monitoring and DSCMRI in the same session. Ten patients had temporal lobe epilepsy (TLE) and seven, epilepsy of extratemporal origin (ExTE). MRI data were compared with EEG findings, and the accuracy of DSC-MRI was analyzed considering spiking rate (number of interictal epileptiform abnormalities, IEA/min) and type of epilepsy. Results: DSC-MRI showed a relevant asymmetry in the frontal, temporal, and occipital regions in eight (47%) of 17 patients, consisting of a relative regional cerebral blood volume (rCBV) increase in these areas. Because this region corresponded to the interictal EEG focus (IEF) or to the hemisphere involved in the genesis of epileptic discharges in most patients showing a higher spiking rate, patients were classified in two groups: patients with high spiking rate (HSR, n = 9) and with low spiking rate (LSR, n = 8); the cutoff corresponded to the median value of IEA/min. The rCBV increase corresponded to the IEF or to the hemisphere involved in the genesis of epileptic discharges in seven (77.7%) of nine HSR patients. No patients with LSR showed significant asymmetries in rCBV pattern. In five of six patients with TLE-HSR (83.3%), DSC-MRI showed a relative rCBV increase concordant with IEF or hemisphere involved in the genesis of epileptic discharges; in patients with ExTE-HSR, the concordance was 66%. Conclusions: DSC-MRI is a noninvasive procedure that may provide useful additional information to lateralize and/or localize the IEF when interictal epileptiform activity is sufficiently elevated.

Original languageEnglish
Pages (from-to)1515-1521
Number of pages7
JournalEpilepsia
Volume43
Issue number12
DOIs
Publication statusPublished - Dec 1 2002

Keywords

  • DSC-MRI
  • EEG
  • Interictal epileptiform abnormalities (IEA)
  • Partial epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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