scholarly journals The role of susceptibility-weighted imaging (SWI) in neuroimaging in children with focal epilepsy

2020 ◽  
Vol 12 (2) ◽  
pp. 105-116
Author(s):  
M. V. Polyanskaya ◽  
A. A. Demushkina ◽  
F. A. Kostylev ◽  
I. G. Vasilyev ◽  
V. A. Chadaev ◽  
...  
Keyword(s):  
Structural Changes ◽  
Focal Epilepsy ◽  
Degradation Products ◽  
Radiology Department ◽  
Russian State ◽  
Epileptogenic Lesion ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
Effective Instrument

Aim. To approve of diagnostic effectiveness of SWAN (SWI) images in revealing of calcium containing epileptogenic substrates in children with resistant focal epilepsy.Materials and methods. The results of MRI in children with refractory focal epilepsy obtained in the Radiology Department of the Russian State Children Hospital in the period from 2018 to 2020 were observed retrospectively. High-resolution epileptological MR protocol used for investigation of 67 children. SWAN was applied in all cases for identification of calcium containing epileptogenic substrates, including cavernomas, DVA syndrome, cortical gangliogliomas, Sturge-Weber syndrome and tuberous sclerosis complex. All images were received by using MRI 3T 750 W Discovery GE.Results. In 17 cases (25%) SWAN provided important diagnostic information about the nature of the of epileptogenic lesion, its prevalence and borders. Additional earlier invisible structural changes were revealed in 2 cases of SWS and 1 cases of FCD; and in 13 cases SWAN gave us possibility to avoid CT for approving calcium in epileptogenic focus.Conclusion. We believe that adding SWAN in to the epileptological MR protocol is the necessary step for optimizing calcium and blood degradation products identification in the structure of potential epileptogenic focuses. Moreover, it would be very effective instrument for differential diagnosis of cerebral structural changes, specifying its etiology and, hence, would have influence on the therapeutic tactic and surgical strategy in children with focal epilepsy.

scholarly journals Role of contrast-free MR-perfusion in the diagnosis of potential epileptogenic foci in children with focal epilepsia

2018 ◽  
Vol 10 (2) ◽  
pp. 6-18
Author(s):  
M. V. Polyanskaya ◽  
A. A. Demushkina ◽  
I. G. Vasiliev ◽  
H. Sh. Gazdieva ◽  
A. A. Kholin ◽  
...  
Keyword(s):  
Focal Epilepsy ◽  
Clinical Status ◽  
Brain Perfusion ◽  
Arterial Perfusion ◽  
Arterial Blood ◽  
Russian State ◽  
Epileptogenic Lesion ◽  
Mri Scans ◽  
Epileptogenic Foci

ASL (Arterial Spin Labeling) – a novel modality of MR angiography – is based on radio-frequency labeling of aqueous protons in the arterial blood; the method is used to monitor blood supply to  organs, including the brain. So far there has been little information on the use of ASL in children with focal epilepsy, especially in the pre-surgery period.Aim:to evaluate the perfusion patterns in seizure-free children with drug resistant focal epilepsy (FE) using the ASL mode of MRI.Materials and methods.We studied the ASL data of 54 (23-boys/31 girls) patients with FE  treated in the Dpt. of Neurology at the Russian State Children Hospital from 2015 to 2018. The  patients’ age varied from 4 months to 17 years. All images were produced with a 3T GE Discovery  750W system.Results. We found several brain perfusion patterns in children with FE; among other factors, those patterns depended on the clinical status of the patient, i. e. the interictal period or the early post- seizure period. The main pattern of the interictal period was characterized by a focal decrease in  perfusion located around a structural focus identified on MRI scans. In the early post-seizure  period, there was an increase in the arterial perfusion in the area of a structural epileptogenic lesion.Conclusion.ASL-MRI is an effective diagnostic method providing more information on children  with FE during their pre-surgery phase. The ASL modality needs further research to rationalize its wider use as a preferred diagnostic tool or as a combination with the more complex PET and SPECT.

scholarly journals Paroxysmal vascular events in Sturge– Weber syndrome: Role of aspirin

2014 ◽  
Vol 9 (1) ◽  
pp. 39 ◽  
Author(s):  
Jyoti Sanghvi ◽  
Sudhir Mehta ◽  
Swati Mulye
Keyword(s):  
Vascular Events ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome

The role of episcleral venous pressure in glaucoma associated with Sturge-Weber syndrome

2012 ◽  
Vol 16 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Tiffany Shiau ◽  
Narendra Armogan ◽  
David B. Yan ◽  
Hugh G. Thomson ◽  
Alex V. Levin
Keyword(s):  
Venous Pressure ◽  
Episcleral Venous Pressure ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome

scholarly journals Infraslow Status Epilepticus: A new form of subclinical status epilepticus recorded in a child with Sturge Weber Syndrome

2015 ◽  
Vol 42 (S1) ◽  
pp. S27-S28
Author(s):  
LE Bello-Espinosa
Keyword(s):  
Status Epilepticus ◽  
Structural Changes ◽  
Continuous Eeg ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
New Form ◽  
Acute Confusion ◽  
Structural Epilepsy ◽  
Focal Status Epilepticus ◽  
Patients With Epilepsy

Background: Analysis of infraslow EEG activity (ISA) has shown potential in the evaluation of patients with epilepsy and in differentiating between focal and generalized epilepsies. The purpose of this report is to present a girl with Sturge-Weber Syndrome (SWS) who was identified to have infraslow status epilepticus (ISSE), which successfully resolved after Midazolam administration Methods: The continuous EEG recording of a 5-yr-old girl with known Structural Epilepsy due to Sturge-Weber is presented. The patient presented to the ED with acute confusion, eye deviation and right hemiparesis similar to two previous admissions. ltm-eeg showed diffuse slowing. DWI obtained within 72-hr showed no ischemic changes, analysis of the EEG nfraslow (ISA) activity was undertaken using LFF 0.01 AND HFF of 0.1 Hz respectively. Results: Continuous subclinical unilateral rhythmic ictal ISA was identified. This was only evident in the left hemisphere which correlated with the structural changes due to SWS. A trial of continuous IV midazolam resulted in immediate resolution of the contralateral hemiparesis and encephalopathy. Conclusion: Continuous prolonged rhythmic ictal Infraslow activity (ISA) can cause super-refractory subclinical focal status epilepticus. This has not previously reported, and we propose this should be called Infraslow status epilepticus (ISSE). ISA analysis should be performed in all patients with unexplained subclinical status epilepticus.

scholarly journals Neuroimaging Abnormalities in Children Presenting With First Onset Apparent Unprovoked Seizures

2018 ◽  
Vol 5 (2) ◽  
pp. 3507-3512
Author(s):  
Dr. Shashibala J Yadav ◽  
Dr. Anu Sharma
Keyword(s):  
White Matter ◽  
Specific Treatment ◽  
Febrile Seizures ◽  
First Episode ◽  
Unprovoked Seizure ◽  
Weber Syndrome ◽  
First Onset ◽  
Sturge Weber Syndrome ◽  
Trained Manpower

Background: Seizures is the most common pediatric neurological disorder. 5-10% percent of children suffer at least one episode of seizure in the first 16 years of life. The incidence is highest in children less than 3 years of age. Epidemiological studies reveal that approximately 1, 50, 000 children will sustain a first-time, unprovoked seizure each year and of these 30,000 will develop epilepsy. Many of the adolescents and adults having epilepsy had their first episode of seizures in childhood. The management of seizures or later epilepsy is more complex in developing countries like India because of ignorance, poverty, stigmatization and lack of resources and trained manpower. The role of neuroimaging in unprovoked seizures has always been a topic of great interest and research. The role of neuroimaging in children with new onset unprovoked seizures is also not well defined and insufficient evidence is available to make a standard recommendation or guidelines for the use of routine neuroimaging in children with first unprovoked seizure. We conducted this study to find out neuroimaging abnormalities in children with first onset unprovoked seizures and to know whether finding of such neuroimaging abnormalities affect the management of these patients. Aims and Objectives: To find out types of neuroimaging abnormalities in children with unprovoked seizures and to know whether finding of such neuroimaging abnormalities affect the management of these patients. Materials and methods: This was a prospective cohort study comprising of children from 6 months to 12 years who have been referred to radiology department for either CT or MRI brain following first episode of unprovoked or complex febrile seizures. The demographics, history and clinical details were noted from case papers. Neuroimaging abnormalities found in these patients were noted and studied. The data was tabulated and analyzed using SPSS 16.0 version software. Results: Total 30 children with unprovoked or complex febrile seizures who were referred to us for neuroimaging were enrolled in this study. 10 (33.33%) patients between 6m to 6 years and remaining 20 (66.66%) were more than 6 years. Most common type of seizures were found to be generalised seizures (60%). CT abnormalities were found in 9 patients (30%). MRI was done in 12 patients abnormalities were seen in 10 patients (33.33%). The most common CT and MRI abnormality found in these patients was volumetric reduction of cerebral hemisphere consistent with cerebral atrophy and Volume loss respectively. The other abnormalities found on neuroimaging included focal hypodense lesions (6.66%), white matter hypo-densities (3.33%), tram-track calcification suggestive of sturge weber syndrome (3.33%) and hemorrhage (3.33 %). MRI abnormalities seen in the patients included atrophic changes (3/12), infarcts (2/12), white matter lesions (2/12), Sturge Weber syndrome (1/12), hemorrhage (1/12) and acute disseminated encephalomyelitis (1/12). Conclusion: Children presenting with first onset unprovoked or complex febrile seizures should undergo neuroimaging, preferably MRI, as part of basic workup. Many of thes children are likely to be having neuroimaging abnormalities which will require specific treatment.

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