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주기편측간질모양방전의 전류원 분포: 바이러스뇌염 환자에서 MRI-확산강조영상과 비교

Current Source Distribution of Periodic Lateralized Epileptiform Discharge: Comparison with Diffusion-Wighted MR Imaging in Viral Encephalitis

김수경|강희영|권오영|김영수|주은정|최낙천|임병훈|손승남
대한신경과학회 (Korean Neurological Association)|2011.08|대한신경과학회지 (Journal of the Korean Neurological Association)|제29권 제3호|pp. 205-213

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참고문헌

키워드

ElectroencephalographyMagnetic resonance imagingCurrent-source analysisViral encephalitisPeriodic lateralized epileptiform discharges
주제분류신경과학

초록

Background: Periodic lateralized epileptiform discharges (PLEDs) are the main electroencephalograph (EEG) findings that imply the existence of acute or subacute structural lesions. The purpose of this study was to investigate the electrophysiologic characteristics of PLEDs by identifying the relationship between the current-source distribution (CSD) of PLEDs and the high signal intensity of diffusion-weighted magnetic resonance imaging (MRI; HSI-DWI) in viral encephalitis. Methods: Six patients were enrolled. Twenty typical EEG, 1-s epochs, including the negative peak of the PLEDs, were averaged into an averaged-PLED (a-PLED). The CSD at the negative peak point of the a-PLED was located on the Talairach human brain map in each patient. The CSDs of the patients were compared with the anatomic locations of encephalitic lesions observed on diffusion-weighted MRI. Results: In all patients, the locations with HSI-DWI were observed in the cortical areas. In two out of the six patients the locations of CSD and those of HSI-DWI were matched. In the other patients, they were partly matched. The matched areas were observed in the frontal, temporal, and parietal areas. The additional areas of CSD were in both insular areas, and those of HSI-DWI were in the frontal, temporal, parietal, and occipital areas. Conclusions: This study showed that the CSDs of PLEDs in viral encephalitis were mostly matched with the HSI-DWI in the cortical area of the frontal, temporal, and parietal areas. The cortical lesion itself in viral encephalitis may be part of the neural generator of PLEDs.

Abstract

Background: Periodic lateralized epileptiform discharges (PLEDs) are the main electroencephalograph (EEG) findings that imply the existence of acute or subacute structural lesions. The purpose of this study was to investigate the electrophysiologic characteristics of PLEDs by identifying the relationship between the current-source distribution (CSD) of PLEDs and the high signal intensity of diffusion-weighted magnetic resonance imaging (MRI; HSI-DWI) in viral encephalitis. Methods: Six patients were enrolled. Twenty typical EEG, 1-s epochs, including the negative peak of the PLEDs, were averaged into an averaged-PLED (a-PLED). The CSD at the negative peak point of the a-PLED was located on the Talairach human brain map in each patient. The CSDs of the patients were compared with the anatomic locations of encephalitic lesions observed on diffusion-weighted MRI. Results: In all patients, the locations with HSI-DWI were observed in the cortical areas. In two out of the six patients the locations of CSD and those of HSI-DWI were matched. In the other patients, they were partly matched. The matched areas were observed in the frontal, temporal, and parietal areas. The additional areas of CSD were in both insular areas, and those of HSI-DWI were in the frontal, temporal, parietal, and occipital areas. Conclusions: This study showed that the CSDs of PLEDs in viral encephalitis were mostly matched with the HSI-DWI in the cortical area of the frontal, temporal, and parietal areas. The cortical lesion itself in viral encephalitis may be part of the neural generator of PLEDs.

참고문헌 (23)

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