Decreased cerebral blood flow during seizures with ictal SPECT injections

Avery, R. A.; Zubal, I. George; Stokking, Rik; Studholme, Colin; Corsi, María; Seibyl, John; Spencer, Susan S.

doi:10.1016/s0920-1211(00)00109-1

Cited by 28 publications

(24 citation statements)

References 42 publications

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“…Seizures in adults and children have been shown to be associated with significant haemodynamic responses using a variety of techniques (Duncan, 1997;Avery et al, 2000;Salek-Haddadi et al, 2002;Gallagher et al, 2008;Roche-Labarbe et al, 2008). A better understanding of how the neonatal cerebral vascular system reacts during and after seizure events, particularly in infants who have already suffered hypoxic injury, is highly desirable and may well have an impact on treatment (Silverstein, 2009).…”

Section: Introductionmentioning

confidence: 99%

Transient haemodynamic events in neurologically compromised infants: A simultaneous EEG and diffuse optical imaging study

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Transient haemodynamic events in neurologically compromised infants: A simultaneous EEG and diffuse optical imaging study

et al. 2011

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“…In the table 3 we can see that the results are better when the change is higher, because the difference between images is well-defined. The average error in all changes was better in sphere 3 and worst in the smallest sphere (1). Perhaps the inserted noise in the images may have caused the best result in sphere 3, therefore sphere 4 possessses more points to be spoiled by noise.…”

Section: Discussionmentioning

confidence: 96%

“…Periictal SPECT is widely available and highly sensitive to determine EZ location [24]. In those patients presenting extra-temporal epilepsy, non-localizing and non-lateralizing ictal and periictal EEG, normal MRI findings or multiple cerebral lesions, the ictal SPECT assumes an exploratory rather than purely complementary role [1,24]. Nonetheless, detect the EZ through a visual side by side ictal and periictal interpretation is very difficult [13].…”

Section: Introductionmentioning

confidence: 99%

Implementation and Test of B.R.A.S.I.L: An Epilepsy Computer-Aided Diagnosis Toolkit

Oliveira

Azevedo-Marques²,

Ana

et al. 2008

2008 11th IEEE International Conference on Computational Science and Engineering

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It may be difficult to detect the epileptic focus through a simple visual interpretation of ictal and periictal SPECT images, placed side-by-side, especially in patients with extra-temporal or non-localizable intractable epilepsy. Surgery is an important option in the treatment of these epileptic patients. Our methodology aids planning the surgical process. It is a variation of SISCOM methodology. The ictal and periictal images are subtracted, after the registration with MR. The next step is calculate the mean and standard deviation in subtracted SPECT image, the voxel values below the mean plus two standard deviations are ignored (zeroed). We developed 400 phantoms to test this methodology with 4 spheres that suffered alteration in theirs voxels values. Alterations had varied from 5% up to 25%, with steps of 5 units. Results have shown that our method had 71.60% and 93.16% of average sensitivity in alterations of 5% and 25%, respectively. Moreover, our technique has been preliminary validated by clinical and surgical outcome of epileptic patients and with other neurological disorders and the results corroborate the potential of the methodology in clinical routine.

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“…hyperperfusion concordant with the seizure focus, in all those with developmental abnormalities confirmed at pathology, as well as those with pathologically proven Rasmussen's encephalitis, a chronic inflammatory condition. This may be particularly helpful in the presence of a normal MRI and is striking in view of the evidence that rCBF does not always increase in seizures in focal epilepsy, with some data to suggest there may be a reduction in rCBF in some cases (Cross et al 1997a, Avery et al 2000. The reason for the increase in ictal rCBF has been assumed to be caused by the increased metabolic demands at the seizure focus, although the stimulus for and control of rCBF remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Correlation of SPECT with pathology and seizure outcome in children undergoing epilepsy surgery

Hartley

Gordon

Harkness³

et al. 2002

Develop Med Child Neuro

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SPECT can be used to image regional cerebral blood flow (rCBF) and has been shown to help localize the seizure focus in partial epilepsies as part of the presurgical evaluation. Few studies have explored the possible relation between preoperative SPECT and underlying pathology, or any relation to postsurgical outcome. In this study preoperative ictal and interictal rCBF in relation to the histopathological diagnosis and outcome in a series of 35 children (24 females, 11 males; mean age 9.6 years, age range 11 months to 18 years) who had undergone resective surgery for epilepsy were retrospectively evaluated. A correlation between ictal hyperperfusion and the underlying responsible pathology was shown, with a consistent ictal increase in perfusion in developmental pathologies and Rasmussen's encephalitis, and consistent interictal hypoperfusion in hippocampal sclerosis (HS). No rCBF study parameter appeared to relate to outcome but in the group with HS the best outcome was seen in those with localizing ictal rCBF. The varied group of pathologies from hemispherectomy had excellent outcome but the SPECT findings had little to contribute over the abnormalities detected on MRI. In conclusion, rCBF studies remain a useful presurgical investigation in children with partial epilepsy, especially where HS, cortical dysplasia, or inflammatory disease are the underlying pathology. However, rCBF studies add little to the investigation of children with seizures secondary to benign tumours or cerebral infarcts, or where hemispherectomy is the likely preferred surgical option.

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Decreased cerebral blood flow during seizures with ictal SPECT injections

Cited by 28 publications

References 42 publications

Transient haemodynamic events in neurologically compromised infants: A simultaneous EEG and diffuse optical imaging study

Transient haemodynamic events in neurologically compromised infants: A simultaneous EEG and diffuse optical imaging study

Implementation and Test of B.R.A.S.I.L: An Epilepsy Computer-Aided Diagnosis Toolkit

Correlation of SPECT with pathology and seizure outcome in children undergoing epilepsy surgery

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