Ictal EEG/fMRI study of vertiginous seizures

Alessandra Morano, Marco Carnì, Sara Casciato, Anna Elisabetta Vaudano, Jinane Fattouch, Martina Fanella, Mariarita Albini, Luca Manfredi Basili, Giulia Lucignani, Marco Scapeccia, Regina Tomassi, Elisabetta Di Castro, Claudio Colonnese, Anna Teresa Giallonardo, Carlo Di Bonaventura

Research output: Contribution to journalArticle

Abstract

Vertigo and dizziness are extremely common complaints, related to either peripheral or central nervous system disorders. Among the latter, epilepsy has to be taken into consideration: indeed, vertigo may be part of the initial aura of a focal epileptic seizure in association with other signs/symptoms, or represent the only ictal manifestation, a rare phenomenon known as “vertiginous” or “vestibular” seizure. These ictal symptoms are usually related to a discharge arising from/involving temporal or parietal areas, which are supposed to be a crucial component of the so-called “vestibular cortex”. In this paper, we describe three patients suffering from drug-resistant focal epilepsy, symptomatic of malformations of cortical development or perinatal hypoxic/ischemic lesions located in the posterior regions, who presented clusters of vertiginous seizures. The high recurrence rate of such events, recorded during video-EEG monitoring sessions, offered the opportunity to perform an ictal EEG/fMRI study to identify seizure-related hemodynamic changes. The ictal EEG/fMRI revealed the main activation clusters in the temporo-parieto-occipital regions, which are widely recognized to be involved in the processing of vestibular information. Interestingly, ictal deactivation was also detected in the ipsilateral cerebellar hemisphere, suggesting the ictal involvement of cortical–subcortical structures known to be part of the vestibular integration network.

Original languageEnglish
Pages (from-to)51-56
Number of pages6
JournalEpilepsy and Behavior
Volume68
DOIs
Publication statusPublished - Mar 1 2017

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Keywords

  • Cerebellum
  • EEG/fMRI
  • Epilepsy
  • MCD
  • Vertigo

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Morano, A., Carnì, M., Casciato, S., Vaudano, A. E., Fattouch, J., Fanella, M., Albini, M., Basili, L. M., Lucignani, G., Scapeccia, M., Tomassi, R., Di Castro, E., Colonnese, C., Giallonardo, A. T., & Di Bonaventura, C. (2017). Ictal EEG/fMRI study of vertiginous seizures. Epilepsy and Behavior, 68, 51-56. https://doi.org/10.1016/j.yebeh.2016.12.031