Cerebral blood flow and temporal lobe epileptogenicity

Martin E. Weinand, L. Philip Carter, Waleed F. El-Saadany, Panayiotis J. Sioutos, David M. Labiner, Kalarickal J. Oommen

Research output: Contribution to journalArticle

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Abstract

Long-term surface cerebral blood flow (CBF) monitoring was performed to test the hypothesis that temporal lobe epileptogenicity is a function of epileptic cortical perfusion. Forty-three bitemporal 2-hour periictal CBF studies were performed in 13 patients. Homotopic regions of temporal cortex maintained interictal epileptic cortical hypoperfusion and nonepileptic normal cortical CBF. At 10 minutes preictus, a statistically significant, sustained increase in CBF was detected on the epileptic temporal lobe. Two minutes preictus, there was approximation of CBF in the epileptic and nonepileptic temporal lobes. Thereafter, electrocorticographic (ECoG) and clinical seizure onset occurred. The linear relationship between CBF in the two hemispheres (epileptic and nonepileptic) was the inverse of normal (y = - 0.347x + 62.767, r = 0.470, df = 95, p < 0.05). The data indicated a direct linear correlation between epileptic cortical CBF and seizure interval (frequency -1), a clinical measure of epileptogenicity (r = 0.610, df = 49, p < 0.05). Epileptogenicity was also found to be a logarithmic function of the difference between nonepileptic and epileptic cortical perfusion (r = 0.564, df = 58, t = 5.20, p < 0.05). The results showed that progressive hypoperfusion of the epileptic focus correlated with a decreased seizure interval (increased epileptogenicity). Increased perfusion of the epileptic focus correlated with an increased seizure interval (decreased epileptogenicity). The fact that CBF alterations precede ECoG seizure activity suggests that vasomotor changes may produce electrical and clinical seizure onset.

Original languageEnglish (US)
Pages (from-to)226-232
Number of pages7
JournalJournal of Neurosurgery
Volume86
Issue number2
StatePublished - Feb 1997

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Cerebrovascular Circulation
Temporal Lobe
Seizures
Perfusion

Keywords

  • cerebral blood flow
  • epilepsy
  • epilepsy surgery
  • epileptogenicity
  • subdural electrode
  • temporal lobe seizure

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Weinand, M. E., Carter, L. P., El-Saadany, W. F., Sioutos, P. J., Labiner, D. M., & Oommen, K. J. (1997). Cerebral blood flow and temporal lobe epileptogenicity. Journal of Neurosurgery, 86(2), 226-232.

Cerebral blood flow and temporal lobe epileptogenicity. / Weinand, Martin E.; Carter, L. Philip; El-Saadany, Waleed F.; Sioutos, Panayiotis J.; Labiner, David M.; Oommen, Kalarickal J.

In: Journal of Neurosurgery, Vol. 86, No. 2, 02.1997, p. 226-232.

Research output: Contribution to journalArticle

Weinand, ME, Carter, LP, El-Saadany, WF, Sioutos, PJ, Labiner, DM & Oommen, KJ 1997, 'Cerebral blood flow and temporal lobe epileptogenicity', Journal of Neurosurgery, vol. 86, no. 2, pp. 226-232.
Weinand ME, Carter LP, El-Saadany WF, Sioutos PJ, Labiner DM, Oommen KJ. Cerebral blood flow and temporal lobe epileptogenicity. Journal of Neurosurgery. 1997 Feb;86(2):226-232.
Weinand, Martin E. ; Carter, L. Philip ; El-Saadany, Waleed F. ; Sioutos, Panayiotis J. ; Labiner, David M. ; Oommen, Kalarickal J. / Cerebral blood flow and temporal lobe epileptogenicity. In: Journal of Neurosurgery. 1997 ; Vol. 86, No. 2. pp. 226-232.
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