TY - JOUR
T1 - Epileptic spikes in Rasmussen's encephalitis
T2 - Migratory pattern and short-term evolution. A MEG study
AU - Rossi Sebastiano, Davide
AU - Visani, Elisa
AU - Duran, Dunja
AU - Freri, Elena
AU - Panzica, Ferruccio
AU - Chiapparini, Luisa
AU - Ragona, Francesca
AU - Granata, Tiziana
AU - Franceschetti, Silvana
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Objective We aimed this study at identifying cortical areas involved in the generation of interictal spikes in Rasmussen's Encephalitis (RE) patients using magnetoencephalography (MEG), at comparing spike localization with the degree of cortical atrophy detected by MRI, and at identifying short-term changes during the follow-up. Methods Five patients with RE underwent two MEG and magnetic resonance imaging (MRI) (six months interval). The sources of visually detected spikes were estimated using equivalent current dipoles technique; these were then superimposed on individual MRI and clustered; the locations of the clusters were related to the MRI stage of cortical atrophy. Results All patients showed spikes and clusters located in different cortical areas in both recordings; the locations had a limited correspondence with cortical atrophy. The second recordings showed changes in the localisation of spikes and clusters, and confirmed the dissimilarities with neuroradiological abnormalities. Conclusions The presence of clusters of spikes of variable localisation suggests that RE progresses in a multifocal and fluctuating manner. The cortical areas most involved in epileptogenesis did not completely coincide with the most atrophic areas. Significance MEG can contribute to evaluating multifocal hemispheric spikes in RE and to better understand the time course of epileptogenic process.
AB - Objective We aimed this study at identifying cortical areas involved in the generation of interictal spikes in Rasmussen's Encephalitis (RE) patients using magnetoencephalography (MEG), at comparing spike localization with the degree of cortical atrophy detected by MRI, and at identifying short-term changes during the follow-up. Methods Five patients with RE underwent two MEG and magnetic resonance imaging (MRI) (six months interval). The sources of visually detected spikes were estimated using equivalent current dipoles technique; these were then superimposed on individual MRI and clustered; the locations of the clusters were related to the MRI stage of cortical atrophy. Results All patients showed spikes and clusters located in different cortical areas in both recordings; the locations had a limited correspondence with cortical atrophy. The second recordings showed changes in the localisation of spikes and clusters, and confirmed the dissimilarities with neuroradiological abnormalities. Conclusions The presence of clusters of spikes of variable localisation suggests that RE progresses in a multifocal and fluctuating manner. The cortical areas most involved in epileptogenesis did not completely coincide with the most atrophic areas. Significance MEG can contribute to evaluating multifocal hemispheric spikes in RE and to better understand the time course of epileptogenic process.
KW - Cluster analysis
KW - Epilepsy
KW - Equivalent current dipoles
KW - Magnetoencephalography
KW - Rasmussen's encephalitis
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U2 - 10.1016/j.clinph.2017.07.401
DO - 10.1016/j.clinph.2017.07.401
M3 - Article
C2 - 28826020
AN - SCOPUS:85027549028
VL - 128
SP - 1898
EP - 1905
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
IS - 10
ER -