Various pathophysiological mechanisms of Todd’s palsy revealed by 1.5-Tesla magnetic resonance imaging including arterial spin labeling perfusion imaging during neurological emergencies

  • Morioka Takato
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Inoha Satoshi
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Mugita Fumihito
    Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
  • Yokomizo Akifumi
    Department of Neurosurgery, Hachisuga Hospital, Munakata, 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

説明

<p>Although Todd’s palsy is a well-known pathological condition, its pathophysiological mechanisms remain unclear. We evaluated two patients using magnetic resonance imaging (MRI), including 1.5-Tesla pseudo-continuous arterial spin labeling (ASL) perfusion imaging, to observe ictal hyperperfusion and associated hemodynamic changes in the peri-rolandic region. In Patient 1, marked ictal ASL hyperperfusion and cytotoxic edema were observed in the interhemispheric cortex of the right peri-rolandic region. Persistence of this edema was associated with left leg palsy lasting 25 days. In Patient 2, prominent ictal ASL hyperperfusion was observed in the right parieto-occipito-temporal lobes without direct involvement of the precentral gyrus. The palsy and MRI findings improved within one day and on Day 4, respectively. We speculate the palsy was caused by transient hypoperfusion of the precentral gyrus, resulting from blood stealing by ictal hyperperfusion. Todd’s palsy may involve various pathophysiological conditions, and combined use of MRI including ASL and electroencephalography is useful in diagnosing this pathophysiology.</p>

収録刊行物

  • Epilepsy & Seizure

    Epilepsy & Seizure 17 (0), n/a-, 2025

    一般社団法人 日本てんかん学会

詳細情報 詳細情報について

  • CRID
    1390023461082084864
  • DOI
    10.3805/eands.a000168
  • ISSN
    18825567
  • 本文言語コード
    en
  • データソース種別
    • JaLC
  • 抄録ライセンスフラグ
    使用不可

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