Detection of subtle periictal hyperperfusion with 1.5-Tesla arterial spin labeling perfusion imaging in a patient with congenital unilateral perisylvian syndrome in a neurological emergency

DOI
  • Morioka Takato
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Mugita Fumihito
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Inoha Satoshi
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Kinoshita Yoshimasa
    Department of Neurosurgery, Munakata Suikokai General Hospital, Fukutsu, Fukuoka, Japan
  • Akiyama Tomoaki
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Shimogawa Takafumi
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Mukae Nobutaka
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Sakata Ayumi
    Department of Clinical Laboratory, Kyushu University Hospital, Fukuoka, Fukuoka, Japan Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Shigeto Hiroshi
    Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
  • Yoshimoto Koji
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan

Description

<p>We made a pathophysiological diagnosis of epileptic seizures in a 50-year-old male with congenital unilateral perisylvian syndrome due to right perisylvian polymicrogyria, using routine electroencephalography (EEG) and 1.5-Tesla arterial spin labeling (ASL) magnetic resonance perfusion imaging. No paroxysmal discharges were recorded on EEG performed 1 h after the generalized convulsive seizure. Pseudo-continuous and pulsed ASL images taken 1 h 30 min and 1 h 15 min after the seizure, respectively, captured subtle periictal hyperperfusion linked to seizure activity via neurovascular coupling at the perisylvian area. In particular, the fusion of ASL images with the sagittal view of a three-dimensional T1-weighted image clearly revealed periictal hyperperfusion at the area of polymicrogyria, indicating intrinsic epileptogenicity. This case report details how adding ASL to routine EEG data can be useful in the pathophysiological diagnosis of epilepsy in neurological emergencies.</p>

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Keywords

Details 詳細情報について

  • CRID
    1390021625620727168
  • DOI
    10.3805/eands.a000164
  • ISSN
    18825567
  • Text Lang
    en
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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