Last modified: 2014-04-03
Abstract
Purpose: To evaluate the relationship between cortical perfusion or venous flow and electrographic activity in the children with seizure using susceptibility weighted imaging (SWI) and electroencephalogrphy (EEG).
Methods: Children presenting with seizures who underwent MRI-SWI and EEG within 24 hours of seizure onset were retrospectively reviewed. The localized area of increased cortical venous flow (SWI+) was assessed using SWI while the abnormal activities such as slowing or epileptiform discharges (EEG+) were investigated on EEG recordings. We defined three groups of patients according to the correlation between MRI-SWI and EEG: (A) no increased venous flow and no abnormal discharges, (B) discordant finding between the SWI+ and EEG+ area, (C) concordant finding between the SWI+ and EEG+ area.
Results: We identified 297 children (194 in group-A, 76 in group-B, and 27 in group-C). The mean age among the three groups was similar (group-A: 3.8±4.6, group-B: 5.0±4.5, group-C: 4.6±4.8 years). The greatest difference among these groups was in seizure frequency and underlying disease. Multiple seizures were revealed more frequently in group-C (12/27, 44.4%) than in group-A (47/194, 24.2%, p=0.026) or group-B (18/76, 23.7%, p=0.041). The incidence of newly-diagnosed epilepsy was significantly higher in group-C (14/27, 51.9%) than in group-A (59/194, 30.4%, p=0.026) or group-B (22/76, 28.9%, p=0.032). By contrast, there were no significant differences in the previous seizure history, seizure types or duration among the three groups.
Conclusion: Seizures with concordant findings between increased venous flow on MRI-SWI and abnormal electrographic activities are more likely to more frequent or real epileptic seizures.Keywords
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