Neuroimaging Correlates of Periodic Discharges : Journal of Clinical Neurophysiology

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Invited Review

Neuroimaging Correlates of Periodic Discharges

Herlopian, Aline*; Struck, Aaron F.; Rosenthal, Eric; Westover, Brandon M.

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Journal of Clinical Neurophysiology 35(4):p 279-294, July 2018. | DOI: 10.1097/WNP.0000000000000466

Abstract

Summary: 

Despite being first described over 50 years ago, periodic discharges continue to generate controversy as to whether they are always, sometimes, or never “ictal.” Investigators and clinicians have proposed adjunctive markers to help clarify this distinction—in particular measures of perfusion and metabolism. Here, we review the growing number of neuroimaging studies using Fluorodeoxyglucose-PET, MRI diffusion, Magnetic resonance perfusion, Single Photon Emission Computed Tomography, and Magnetoencepgalography to gain further insight into the physiology and clinical significance of periodic discharges. To date, however, no definitive consensus exists regarding the features of periodic discharges that warrant treatment intensification. However, an emerging consilience among neuroimaging modalities suggests that periodic discharges can induce a hyperexcitatory state with associated hypermetabolism and hyperperfusion, which may result in local metabolic failure.

Copyright © 2018 by the American Clinical Neurophysiology Society

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