EEG-fMRI as an useful tool to detect epileptic foci associated with secondary bilateral synchrony

详细信息    查看全文

• 作者：Paolo Borelli ; Mirko Avesani ; Emanuela Formaggio ; Silvia Francesca Storti ; Tiziano Zanoni ; Giuseppe Moretto ; Antonio Fiaschi ; Roberto Cerini ; Paolo Manganotti
• 关键词：EEG fMRI ; Secondary bilateral synchrony ; Criptogenetic epilepsy ; Epilepsy surgery
• 刊名：Seizure
• 出版年：2010
• 出版时间：November 2010
• 年：2010
• 卷：19
• 期：9
• 页码：605-608
• 全文大小：619 K

文摘

Introduction

Tailoring the epileptic cortex is the key issue in the pre-surgical work-up of patients with pharmacoresistant focal epilepsy. Not always, however, the conventional MRI and the scalp EEG are able to provide the information needed to address this issue since the imaging may be normal (criptogenetic epilepsy) and the EEG, even ictal, poorly localizing.

Patient and methods

We present a case of focal criptogenetic epilepsy with speech arrest seizures and bilateral synchronous spike and wave scalp EEG pattern (secondary bilateral synchrony). The patient underwent an EEG-fMRI continuous co-registration.

Results

The EEG-fMRI showed a clear cut activation of a BOLD signal during the epileptic discharge over the left Supplementary Motor Area (SMA) and, on lesser degree, over the homolateral motor strip.

Discussion

Knowledge and expertise about this technique has greatly increased over the last few years making it an useful tool for localizing purposes specially in patients with ambiguous scalp EEG and normal MRI just like the one we presented.