title: Ictal EEG/fMRI study of vertiginous seizures.
abstract: Vertigo and dizziness are extremely common complaints, related to either peripheral or central nervous system disorders. Among the latter, epilepsy has to be taken into consideration: indeed, vertigo may be part of the initial aura of a focal epileptic seizure in association with other signs/symptoms, or represent the only ictal manifestation, a rare phenomenon known as "vertiginous" or "vestibular" seizure. These ictal symptoms are usually related to a discharge arising from/involving temporal or parietal areas, which are supposed to be a crucial component of the so-called "vestibular cortex". In this paper, we describe three patients suffering from drug-resistant focal epilepsy, symptomatic of malformations of cortical development or perinatal hypoxic/ischemic lesions located in the posterior regions, who presented clusters of vertiginous seizures. The high recurrence rate of such events, recorded during video-EEG monitoring sessions, offered the opportunity to perform an ictal EEG/fMRI study to identify seizure-related hemodynamic changes. The ictal EEG/fMRI revealed the main activation clusters in the temporo-parieto-occipital regions, which are widely recognized to be involved in the processing of vestibular information. Interestingly, ictal deactivation was also detected in the ipsilateral cerebellar hemisphere, suggesting the ictal involvement of cortical-subcortical structures known to be part of the vestibular integration network.
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Morano
authors.affiliation: Department of Molecular medicine, University "Sapienza", Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carnì
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Casciato
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Nuovo Ospedale Civile S. Agostino Estense (NOCSAE) Hospital, Modena, Italy.
authors.forename: Anna Elisabetta
authors.initials: AE
authors.lastname: Vaudano
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Jinane
authors.initials: J
authors.lastname: Fattouch
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Fanella
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Mariarita
authors.initials: M
authors.lastname: Albini
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Luca Manfredi
authors.initials: LM
authors.lastname: Basili
authors.affiliation: Neuroradiology Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Lucignani
authors.affiliation: Neuroradiology Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Scapeccia
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Regina
authors.initials: R
authors.lastname: Tomassi
authors.affiliation: Department of Molecular medicine, University "Sapienza", Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Di Castro
authors.affiliation: Neuroradiology Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy; Neuroradiology Unit, IRCCS "Neuromed", Pozzilli, IS, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Colonnese
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy.
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
authors.affiliation: Epilepsy Unit, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy. Electronic address: c_dibonaventura@yahoo.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Bonaventura
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012640:Seizures / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Cerebellum; EEG/fMRI; Epilepsy; MCD; Vertigo