Diffusion changes in status epilepticus

Wieshmann, UC; Symms,; Shorvon, SD

doi:10.1016/s0140-6736(05)63083-8

Cited by 126 publications

(84 citation statements)

References 4 publications

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“…However a significant correlation was found between the extent of edema and the total duration of NCS in animals of the chloralose group. Several papers, both in humans and animals, report that (non)convulsive status epilepticus causes changes in the redistribution of intracellular and extracellular water presumably due to cytotoxic edema (Chu et al, 2001;Wall et al, 2000;Wieshmann et al, 1997) A possible link between edema and electric seizure is supported by the observation that the incidence of NCS in this study (12/13) was significantly higher in those animals of both groups where the extent of edema was higher than 10 %.…”

Section: Discussionsupporting

confidence: 57%

Alpha-chloralose is a suitable anesthetic for chronic focal cerebral ischemia studies in the rat: A comparative study

2008

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Abstractα-chloralose is widely used as an anesthetic in studies of the cerebrovasculature because it provides robust metabolic and hemodynamic responses to functional stimulation. However, there have been no controlled studies of focal ischemia in the rat under α-chloralose anesthesia. Artificially ventilated rats were prepared using 1.2−1.5 % isoflurane anesthesia for filament occlusion of the right middle cerebral artery (MCA), and anesthesia was either switched to α-chloralose (60 mg/kg bolus, 30 mg/ kg/hr; n=10) or was maintained on 1% isoflurane (n=10). Following temporary MCA occlusion EEG was monitored from a screw electrode and changes in cerebral blood flow (rCBF) measured with a laser Doppler probe placed over the ischemic cortex. This study shows that α-chloralose is a safe anesthetic for ischemia studies and provides excellent survival. Compared with isoflurane, the cortical and total infarct volumes are larger in the α-chloralose anesthetized animals, while the functional outcome at 72 hours is similar. The total duration of peri-infarct flow transients (PIFTs) is also significantly longer in α-chloralose anesthetized animals. The average amplitude of the flow transients showed a good correlation with the extent of edema in all animals as did the total duration of non-convulsive seizures (NCS) in the α-chloralose anesthetized animals.

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Section: Discussionsupporting

confidence: 57%

Alpha-chloralose is a suitable anesthetic for chronic focal cerebral ischemia studies in the rat: A comparative study

2008

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“…It is difficult to distinguish between cerebral damage due to hypoglycemia, SE or hypoxia/ischemia. Differences in patterns of cerebral involvement between SE and ischemia [18,19] have not been consistently documented. Certain similarities in MRI findings between partial status epilepticus in adults and ischemic stroke [20] have been described.…”

Section: Discussionmentioning

confidence: 99%

Unilateral cortical necrosis following status epilepticus with hypoglycemia

Christiaens

Mewasingh

Christophe

et al. 2003

Brain and Development

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Isolated status epilepticus or severe hypoglycemia rarely causes irreversible focal neurologic deficits in children. We describe three children who presented with status epilepticus and prolonged hypoglycemia resulting in hemiplegia due to unilateral hemispheric damage. The non-vascular cortical topography of the lesions is consistent with selective neuronal necrosis, confirmed by histopathology in one patient. This suggests increased neuronal vulnerability to necrosis secondary to energy failure resulting from combination of hypoglycemia and status epilepticus. q

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“…In recording ictal SPECTs, the interictal SPECT is helpful in determining the extent of blood flow changes between the two conditions (83). Recent data from animal models and case reports on patients suggest that diffusionweighted magnetic resonance imaging (DWI) may be an additional noninvasive technique for localization of the epileptogenic zone (84)(85)(86)(87), and preliminary data suggest that it may be particularly helpful in patients with lesional epilepsy (88). Surface EEG is characterized by a higher incidence of interictal spikes compared to HS (89).…”

Section: General Considerationsmentioning

confidence: 99%

Temporal Lobe Epilepsy: When Are Invasive Recordings Needed?

2000

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Summary:Temporal lobe epilepsy (TLE) is the most common type of medically intractable partial epilepsy amenable to surgery. In the majority of cases, the underlying pathology in temporal lobe epilepsy is mesial temporal sclerosis (MTS). Whereas historically invasive recordings were required for most epilepsy surgeries, indications have dramatically changed since the introduction of high-resolution MRI, which uncovers structural lesions in a high percentage of cases. No invasive recordings are required to perform a temporal lobectomy in patients with intractable epilepsy who have structural imaging suggesting unilateral MTS and concordant interictal and ictal surface EEG recordings, functional imaging, and clinical findings. Invasive testing is needed if there is evidence of bitemporal MTS on structural imaging and/or electrophysiologically, and additional information from functional imaging, neuropsychology, and the intracarotid amobarbital (Wada) test also does not help to lateralize the epileptogenic zone. Depth electrodes can be particularly helpful in this setting. However, no surgery is indicated, even without invasive recordings, if bitemporalindependent seizures are recorded by surface EEG and all additional testing is inconclusive. Other etiologies of TLE such as a tumor, vascular malformation, encephalomalacia, or congenital developmental abnormality account for about 30% of all patients who undergo epilepsy surgery. Epilepsy surgery is indicated after limited electrophysiologic investigations if neuroimaging and electrophysiology converge. However, approaches for resection in lesional temporal lobe epilepsy vary among centers. Completeness of resection is crucial and invasive recordings may be needed to guide the resection by mapping eloquent cortex and/or to determine the extent of the non-MRI-visible epileptogenic area. Specific approaches for the different pathologies are discussed because there is evidence that the relationship between the lesions visible on MRI and the epileptogenic zone varies among lesions of different pathologies, and therefore variable surgical strategies must be applied. Key Words: Temporal lobe-Epilepsy-Electrodes, implanted-Magnetic resonance imaging-Brain neoplasms. HISTORICAL PERSPECTIVES: INVASIVE RECORDINGS FOR EPILEPSY SURGERYThe pioneers of epilepsy surgery utilized clinical findings and seizure semiology to localize the epilepsy and to guide the neurosurgical intervention. This is illustrated by Victor Horsley's first neurosurgical intervention at Queens Square in 1886. The patient was a 22-year-old Scotsman who had a posttraumatic epilepsy. He had very frequent focal motor seizures characterized by a clear march. The diagnosis of "scar involving the hinder end of the superior frontal sulcus" was made according to the ictal semiology and the seizures stopped after surgical removal of the scar. Apart from semiologic analysis of the seizures, additional information was obtained by intraoperative cortical stimulations to reproduce the patient's seizure semiology and to ...

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Diffusion changes in status epilepticus

Cited by 126 publications

References 4 publications

Alpha-chloralose is a suitable anesthetic for chronic focal cerebral ischemia studies in the rat: A comparative study

Alpha-chloralose is a suitable anesthetic for chronic focal cerebral ischemia studies in the rat: A comparative study

Unilateral cortical necrosis following status epilepticus with hypoglycemia

Temporal Lobe Epilepsy: When Are Invasive Recordings Needed?

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