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An atypical progression of rolandic epilepsy: the value of single-photon emission computerised tomography co-registered to magnetic resonance imaging

R. Andrade, A. García-Espinosa, A. Machado-Rojas, A. de la Cruz-Turruelles [REV NEUROL 2009;49:639-644] PMID: 20013716 DOI: https://doi.org/10.33588/rn.4912.2009203

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Volumen 49 | Number 12 | Nº of views of the article 5.756 | Nº of PDF downloads 587 | Article publication date 16/12/2009

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ABSTRACT

INTRODUCTION The complicated forms of rolandic epilepsy progress with a continuous spike-wave pattern in slow-wave sleep. Experiments conducted in cats suggest that this pattern can only appear if there is bilateral thalamic insult.

AIM To determine whether thalamic hypoperfusion is associated with the complicated variants of rolandic epilepsy.

PATIENTS AND METHODS A group of 24 children were studied over a period of six years following their first epileptic seizure. During the follow-up an interictal magnetic resonance scan and single-photon emission computerised tomography (SPECT) were performed. Results were examined to ascertain whether there were asymmetries in the distribution of cerebral blood flow through structures, using parametric statistical maps. The brain SPECT was performed when progression to atypical benign partial epilepsy in infancy was diagnosed and in typical forms of rolandic epilepsy when there was some mild neuropsychological deficit that led the specialist to suspect the existence of a focal cortical lesion.

RESULTS Bilateral thalamic hypoperfusion was found in all patients diagnosed with atypical benign partial epilepsy in infancy, which was correlated with the presence of continuous spike-waves during the slow-wave phase of non-REM sleep.

CONCLUSIONS Bilateral thalamic hypoperfusion seems to be a necessary condition for the atypical progression of rolandic epilepsy. KeywordsBenign partial epilepsy in infancy Brain maturation disorder Conduct disorders Rolandic epilepsy Secondary bilateral synchrony SPECT CategoriesEpilepsias y síndromes epilépticos Neurología del Lenguaje y la Comunicación Técnicas exploratorias

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An atypical progression of rolandic epilepsy: the value of single-photon emission computerised tomography co-registered to magnetic resonance imaging

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