CEREBELLAR CHANGES IN PARTIAL SEIZURES - CLINICAL CORRELATIONS OF QUANTITATIVE SPECT AND MRI ANALYSIS

Citation
Ni. Bohnen et al., CEREBELLAR CHANGES IN PARTIAL SEIZURES - CLINICAL CORRELATIONS OF QUANTITATIVE SPECT AND MRI ANALYSIS, Epilepsia, 39(6), 1998, pp. 640-650
Citations number
44
Categorie Soggetti
Clinical Neurology
Journal title
ISSN journal
00139580
Volume
39
Issue
6
Year of publication
1998
Pages
640 - 650
Database
ISI
SICI code
0013-9580(1998)39:6<640:CCIPS->2.0.ZU;2-Q
Abstract
Purpose: To determine the frequency and patterns of periictal cerebell ar hyperperfusion, whether it is associated with increased cerebellar atrophy, and whether cerebellar hyperperfusion and cerebellar atrophy are associated with predisposing clinical factors or with the outcome of epilepsy surgery. Methods: Periictal and interictal SPECT scans and volumetric brain magnetic resonance imaging(MRT) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcome s assessed. Results: Significant periictal cerebellar hyperperfusion w as found in 26 (48.1%) patients, of whom 18 had CCH, two had homolater al cerebellar hyperperfusion (HCH), and six had symmetrical bilateral hyperperfusion (BCH). No relation found between the site of the SPECT seizure localization and the presence or type of cerebellar hyperperfu sion. CCH was more common when the injected seizure involved unilatera l clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume(cerebellar volume/cerebral volume) was correlated with a greate r seizure frequency (R-s = -0.30; p < 0.05) but not with the duration of epilepsy. There was no difference in the cerebellar volumes between the different patterns of cerebellar perfusion (p > 0.05). However, p atients without a focal structural MRI lesion had significantly smalle r cerebellar volumes (p < 0.05). In patients who underwent epilepsy su rgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excel lent outcome (10.6 vs. 11.8%; p = 0.08). Conclusions: Periictal change s in cerebellar perfusion, particularly CCH, are common in patients wi th intractable partial epilepsy. However, periictal hyperperfusion doe s not appear to be a major contributor to the development of cerebella r atrophy.