Epileptogenic developmental venous anomaly: insights from simultaneous EEG/fMRI

Scheidegger, Olivier; Wiest, Roland; Jann, Kay; König, Thomas; Meyer, Klaus; Hauf, Martinus (2013). Epileptogenic developmental venous anomaly: insights from simultaneous EEG/fMRI. Clinical EEG and neuroscience, 44(2), pp. 157-160. London: Sage 10.1177/1550059412464463

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Developmental venous anomalies (DVAs) are associated with epileptic seizures; however, the role of DVA in the epileptogenesis is still not established. Simultaneous interictal electroencephalogram/functional magnetic resonance imaging (EEG/fMRI) recordings provide supplementary information to electroclinical data about the epileptic generators, and thus aid in the differentiation of clinically equivocal epilepsy syndromes. The main objective of our study was to characterize the epileptic network in a patient with DVA and epilepsy by simultaneous EEG/fMRI recordings. A 17-year-old woman with recently emerging generalized tonic-clonic seizures, and atypical generalized discharges, was investigated using simultaneous EEG/fMRI at the university hospital. Previous high-resolution MRI showed no structural abnormalities, except a DVA in the right frontal operculum. Interictal EEG recordings showed atypical generalized discharges, corresponding to positive focal blood oxygen level dependent (BOLD) correlates in the right frontal operculum, a region drained by the DVA. Additionally, widespread cortical bilateral negative BOLD correlates in the frontal and parietal lobes were delineated, resembling a generalized epileptic network. The EEG/fMRI recordings support a right frontal lobe epilepsy, originating in the vicinity of the DVA, propagating rapidly to both frontal and parietal lobes, as expressed on the scalp EEG by secondary bilateral synchrony. The DVA may be causative of focal epilepsies in cases where no concomitant epileptogenic lesions can be detected. Advanced imaging techniques, such as simultaneous EEG/fMRI, may thus aid in the differentiation of clinically equivocal epilepsy syndromes.

Item Type: Journal Article (Original Article)
Division/Institute: 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
07 Faculty of Human Sciences > Institute of Psychology > Experimental Psychology and Neuropsychology
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Psychiatric Neurophysiology (discontinued)
UniBE Contributor: Scheidegger, Olivier; Wiest, Roland; Jann, Kay; König, Thomas and Hauf, Martinus
Subjects: 600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology
ISSN: 1550-0594
Publisher: Sage
Language: English
Submitter: Factscience Import
Date Deposited: 04 Oct 2013 14:36
Last Modified: 07 Jul 2014 17:52
Publisher DOI: 10.1177/1550059412464463
PubMed ID: 23396079
Web of Science ID: 000321216200007
URI: http://boris.unibe.ch/id/eprint/14347 (FactScience: 221297)

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