Magnetic resonance imaging findings in focal-onset status epilepticus
Sarria-Estrada, Silvana (Universitat Autònoma de Barcelona. Departament de Medicina)
Santamarina, Estevo (Universitat Autònoma de Barcelona. Departament de Medicina)
Quintana, Manuel (Universitat Autònoma de Barcelona. Departament de Medicina)
Pareto, Deborah (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sueiras, Maria (Hospital Universitari Vall d'Hebron)
Auger, Cristina (Hospital Universitari Vall d'Hebron)
Toledo, Manuel (Hospital Universitari Vall d'Hebron)
Rovira, Alex (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2022
Resum:	Background and purpose: Magnetic resonance imaging (MRI) is commonly used in the diagnostic work-up for status epilepticus (SE). The purpose of this study was to characterize MRI features in SE patients and determine their association with clinical and electroencephalography (EEG) findings. The mid-term consequences of baseline MRI features were also analysed. Methods: This is a prospective study including consecutive patients with SE who underwent brain MRI within 240 h after SE onset. The MRI protocol included T1-weighted (T1WI), T2-weighted (T2W), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) sequences. Follow-up MRI was performed after SE resolution in some patients. Results: Sixty patients (56. 7% men, mean age 58. 3 years) were included. SE-related MRI abnormalities were seen in 31 (51. 7%), manifesting as hyperintensities on T2W/FLAIR imaging (58. 1%) and DWI (74. 2%) sequences. Hippocampal and pulvinar involvement was seen in 58. 0% and 25. 8% of patients, respectively. MRI abnormalities were associated with a longer SE duration (p = 0. 013) and the presence of lateralized periodic discharges (LPDs) on EEG (p < 0. 001). Amongst the 33 follow-up MRIs, nine (27. 3%) showed mesial temporal sclerosis (MTS), which was associated with severe clinical status (p = 0. 031), hippocampal oedema (p = 0. 001) and LPDs (p = 0. 001) at baseline. A poorer clinical outcome was associated with baseline T2W/FLAIR imaging hyperintensities (p = 0. 003). Conclusion: MRI showed abnormalities in more than half of SE patients. A longer SE duration and LPDs on EEG were associated with SE-related MRI abnormalities and the development of MTS.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Diffusion-weighted imaging ; Magnetic resonance imaging ; Seizures ; Status epilepticus ; Epilepsy
Publicat a:	European Journal of Neurology, Vol. 29 Núm. 1 (january 2022) , p. 3-11, ISSN 1468-1331

DOI: 10.1111/ene.15065

11 p, 2.1 MB

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