Cerebellar changes in partial seizures: Clinical correlations of quantitative SPECT and MRI analysis

Nicolaas I. Bohnen, Terence J. O'Brien, Brian P. Mullan, Elson L. So

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Purpose: To determine the frequency and patterns of periictal cerebellar 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 (MRI) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcomes assessed. Results: Significant periictal cerebellar hyperperfusion was found in 26 (48.1%) patients, of whom 18 had CCH, two had homolateral 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 hyperperfusion. CCH was more common when the injected seizure involved unilateral clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume (cerebellar volume/cerebral volume) was correlated with a greater 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, patients without a focal structural MRI lesion had significantly smaller cerebellar volumes (p < 0.05). In patients who underwent epilepsy surgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excellent outcome (10.6 vs. 11.8%; p = 0.08). Conclusions: Periictal changes in cerebellar perfusion, particularly CCH, are common in patients with intractable partial epilepsy. However, periictal hyperperfusion does not appear to be a major contributor to the development of cerebellar atrophy.

Original languageEnglish (US)
Pages (from-to)640-650
Number of pages11
JournalEpilepsia
Volume39
Issue number6
DOIs
StatePublished - 1998

Fingerprint

Single-Photon Emission-Computed Tomography
Seizures
Magnetic Resonance Imaging
Atrophy
Partial Epilepsy
Epilepsy
Causality
Motor Activity
Perfusion
Brain

Keywords

  • Cerebellar atrophy
  • Cerebellar hyperperfusion
  • MRI
  • Partial epilepsy
  • SPECT

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Cerebellar changes in partial seizures : Clinical correlations of quantitative SPECT and MRI analysis. / Bohnen, Nicolaas I.; O'Brien, Terence J.; Mullan, Brian P.; So, Elson L.

In: Epilepsia, Vol. 39, No. 6, 1998, p. 640-650.

Research output: Contribution to journalArticle

Bohnen, Nicolaas I. ; O'Brien, Terence J. ; Mullan, Brian P. ; So, Elson L. / Cerebellar changes in partial seizures : Clinical correlations of quantitative SPECT and MRI analysis. In: Epilepsia. 1998 ; Vol. 39, No. 6. pp. 640-650.
@article{434578e809fa4d13a0ed7b226d8402e8,
title = "Cerebellar changes in partial seizures: Clinical correlations of quantitative SPECT and MRI analysis",
abstract = "Purpose: To determine the frequency and patterns of periictal cerebellar 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 (MRI) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcomes assessed. Results: Significant periictal cerebellar hyperperfusion was found in 26 (48.1{\%}) patients, of whom 18 had CCH, two had homolateral 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 hyperperfusion. CCH was more common when the injected seizure involved unilateral clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume (cerebellar volume/cerebral volume) was correlated with a greater 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, patients without a focal structural MRI lesion had significantly smaller cerebellar volumes (p < 0.05). In patients who underwent epilepsy surgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excellent outcome (10.6 vs. 11.8{\%}; p = 0.08). Conclusions: Periictal changes in cerebellar perfusion, particularly CCH, are common in patients with intractable partial epilepsy. However, periictal hyperperfusion does not appear to be a major contributor to the development of cerebellar atrophy.",
keywords = "Cerebellar atrophy, Cerebellar hyperperfusion, MRI, Partial epilepsy, SPECT",
author = "Bohnen, {Nicolaas I.} and O'Brien, {Terence J.} and Mullan, {Brian P.} and So, {Elson L.}",
year = "1998",
doi = "10.1111/j.1528-1157.1998.tb01433.x",
language = "English (US)",
volume = "39",
pages = "640--650",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Cerebellar changes in partial seizures

T2 - Clinical correlations of quantitative SPECT and MRI analysis

AU - Bohnen, Nicolaas I.

AU - O'Brien, Terence J.

AU - Mullan, Brian P.

AU - So, Elson L.

PY - 1998

Y1 - 1998

N2 - Purpose: To determine the frequency and patterns of periictal cerebellar 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 (MRI) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcomes assessed. Results: Significant periictal cerebellar hyperperfusion was found in 26 (48.1%) patients, of whom 18 had CCH, two had homolateral 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 hyperperfusion. CCH was more common when the injected seizure involved unilateral clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume (cerebellar volume/cerebral volume) was correlated with a greater 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, patients without a focal structural MRI lesion had significantly smaller cerebellar volumes (p < 0.05). In patients who underwent epilepsy surgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excellent outcome (10.6 vs. 11.8%; p = 0.08). Conclusions: Periictal changes in cerebellar perfusion, particularly CCH, are common in patients with intractable partial epilepsy. However, periictal hyperperfusion does not appear to be a major contributor to the development of cerebellar atrophy.

AB - Purpose: To determine the frequency and patterns of periictal cerebellar 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 (MRI) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcomes assessed. Results: Significant periictal cerebellar hyperperfusion was found in 26 (48.1%) patients, of whom 18 had CCH, two had homolateral 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 hyperperfusion. CCH was more common when the injected seizure involved unilateral clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume (cerebellar volume/cerebral volume) was correlated with a greater 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, patients without a focal structural MRI lesion had significantly smaller cerebellar volumes (p < 0.05). In patients who underwent epilepsy surgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excellent outcome (10.6 vs. 11.8%; p = 0.08). Conclusions: Periictal changes in cerebellar perfusion, particularly CCH, are common in patients with intractable partial epilepsy. However, periictal hyperperfusion does not appear to be a major contributor to the development of cerebellar atrophy.

KW - Cerebellar atrophy

KW - Cerebellar hyperperfusion

KW - MRI

KW - Partial epilepsy

KW - SPECT

UR - http://www.scopus.com/inward/record.url?scp=0031802089&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031802089&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1157.1998.tb01433.x

DO - 10.1111/j.1528-1157.1998.tb01433.x

M3 - Article

C2 - 9637607

AN - SCOPUS:0031802089

VL - 39

SP - 640

EP - 650

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 6

ER -