title: Relationship between cortex and pulvinar abnormalities on diffusion-weighted imaging in status epilepticus.
abstract: The aim of this study was to analyze the pattern of magnetic resonance diffusion-weighted imaging (DWI) findings in status epilepticus in terms of clinical characteristics. Participants comprised 106 patients with status epilepticus who were admitted to our hospital and underwent DWI. Forty-five patients (42.5 %) showed abnormal findings on DWI and were divided into two groups, comprising 26 patients (24.5 %) with cortex lesions alone and 19 patients (17.9 %) with cortex and pulvinar lesions in the same hemisphere. A long duration of status epilepticus (>120 min) tended to be more prevalent among patients with cortex and pulvinar lesions (57.9 %) than among patients with cortex lesions alone (30.8 %) by univariate and multivariate analyses. Todd's palsy tended to be more frequent in patients with abnormalities on DWI (24/45, 53.3 %) than in patients with normal DWI (21/61, 34.4 %). Six of the 26 patients with cortex lesions alone (23.1 %) had taken anti-epileptic drugs before the attack compared to none of the 19 patients with both cortex and pulvinar lesions. The trend toward a longer duration of status epilepticus in patients with both cortex and pulvinar lesions favors a spreading pattern of seizure discharge from cortex to pulvinar via cortico-pulvinar pathways, and anti-epileptic drugs might, to some extent, prevent spreading of seizure discharge from cortex to pulvinar. In addition, existence of high-intensity areas on DWI at the onset of epilepsy may be a predictive factor for the occurrence of Todd's palsy.
authors.affiliation: Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.|Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakae
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Ryoo
authors.initials: R
authors.lastname: Yamamoto
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Dobashi
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawabata
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Yokoyama
authors.affiliation: Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Higashiyama
authors.affiliation: Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.affiliation: Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Johkura
authors.affiliation: Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. ftanaka@yokohama-cu.ac.jp.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology; D020649:Pulvinar / Q000473:pathology*; D013226:Status Epilepticus / Q000473:pathology* / Q000503:physiopathology*; D055815:Young Adult
keywords: Anti-epileptic drugs; Cortico-pulvinar pathway; Diffusion-weighted imaging; Duration of status epilepticus; Status epilepticus; Todd’s palsy