Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report
Summary Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet...
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| Veröffentlicht in: | Epilepsia (Copenhagen) 2009-06, Vol.50 (6), p.1624-1631 |
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| creator | Leal, Alberto J.R. Monteiro, José P. Secca, Mário Forjaz Jordão, Constança |
| description | Summary
Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet been demonstrated, owing to the limited spatial–temporal resolution of available functional mapping. We studied a patient with epilepsy associated with HH and gelastic epilepsy. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of several seizure events were obtained, with blood oxygen level dependent (BOLD) activation of the hamartoma, and left hemisphere hypothalamus, hippocampus, parietal–occipital area, cingulate gyrus, and dorsal–lateral frontal area. Integration of regional BOLD kinetics and EEG power dynamics strongly suggests propagation of the epileptic activity from the HH through the left fornix to the temporal lobe, and later through the cingulate fasciculus to the left frontal lobe. The EEG/fMRI method has the spatial–temporal resolution to study the dynamics of seizure activity, with detailed demonstration of origin and propagation pathways. |
| doi_str_mv | 10.1111/j.1528-1167.2008.01810.x |
| format | Article |
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Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet been demonstrated, owing to the limited spatial–temporal resolution of available functional mapping. We studied a patient with epilepsy associated with HH and gelastic epilepsy. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of several seizure events were obtained, with blood oxygen level dependent (BOLD) activation of the hamartoma, and left hemisphere hypothalamus, hippocampus, parietal–occipital area, cingulate gyrus, and dorsal–lateral frontal area. Integration of regional BOLD kinetics and EEG power dynamics strongly suggests propagation of the epileptic activity from the HH through the left fornix to the temporal lobe, and later through the cingulate fasciculus to the left frontal lobe. The EEG/fMRI method has the spatial–temporal resolution to study the dynamics of seizure activity, with detailed demonstration of origin and propagation pathways.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/j.1528-1167.2008.01810.x</identifier><identifier>PMID: 19183218</identifier><identifier>CODEN: EPILAK</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents ; Biological and medical sciences ; BOLD ; Brain - blood supply ; Brain - pathology ; Brain Mapping ; Child, Preschool ; EEG‐fMRI ; Electroencephalography - methods ; Epilepsies, Partial - complications ; Epilepsies, Partial - pathology ; Epilepsy ; Functional mapping ; Hamartoma - complications ; Hamartoma - pathology ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Hypothalamic Diseases - complications ; Hypothalamic Diseases - pathology ; Hypothalamic hamartoma ; Image Processing, Computer-Assisted - methods ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Oxygen - blood ; Pharmacology. Drug treatments ; Seizure</subject><ispartof>Epilepsia (Copenhagen), 2009-06, Vol.50 (6), p.1624-1631</ispartof><rights>Wiley Periodicals, Inc. © 2008 International League Against Epilepsy</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4780-68d0987036d11dd954eb60883d45a9854ce415f4fd7cbe37f3b6a3ffb6f7f38c3</citedby><cites>FETCH-LOGICAL-c4780-68d0987036d11dd954eb60883d45a9854ce415f4fd7cbe37f3b6a3ffb6f7f38c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1528-1167.2008.01810.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1528-1167.2008.01810.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21674675$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19183218$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leal, Alberto J.R.</creatorcontrib><creatorcontrib>Monteiro, José P.</creatorcontrib><creatorcontrib>Secca, Mário Forjaz</creatorcontrib><creatorcontrib>Jordão, Constança</creatorcontrib><title>Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report</title><title>Epilepsia (Copenhagen)</title><addtitle>Epilepsia</addtitle><description>Summary
Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet been demonstrated, owing to the limited spatial–temporal resolution of available functional mapping. We studied a patient with epilepsy associated with HH and gelastic epilepsy. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of several seizure events were obtained, with blood oxygen level dependent (BOLD) activation of the hamartoma, and left hemisphere hypothalamus, hippocampus, parietal–occipital area, cingulate gyrus, and dorsal–lateral frontal area. Integration of regional BOLD kinetics and EEG power dynamics strongly suggests propagation of the epileptic activity from the HH through the left fornix to the temporal lobe, and later through the cingulate fasciculus to the left frontal lobe. The EEG/fMRI method has the spatial–temporal resolution to study the dynamics of seizure activity, with detailed demonstration of origin and propagation pathways.</description><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents</subject><subject>Biological and medical sciences</subject><subject>BOLD</subject><subject>Brain - blood supply</subject><subject>Brain - pathology</subject><subject>Brain Mapping</subject><subject>Child, Preschool</subject><subject>EEG‐fMRI</subject><subject>Electroencephalography - methods</subject><subject>Epilepsies, Partial - complications</subject><subject>Epilepsies, Partial - pathology</subject><subject>Epilepsy</subject><subject>Functional mapping</subject><subject>Hamartoma - complications</subject><subject>Hamartoma - pathology</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Hypothalamic Diseases - complications</subject><subject>Hypothalamic Diseases - pathology</subject><subject>Hypothalamic hamartoma</subject><subject>Image Processing, Computer-Assisted - methods</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Oxygen - blood</subject><subject>Pharmacology. Drug treatments</subject><subject>Seizure</subject><issn>0013-9580</issn><issn>1528-1167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUFv3CAQhVGVqNls-hcqLs3NW1hswJV6iKKkiRQpPTRnNMaQZWUbF3AT__vi7io9tlwY8b43DDyEMCUbmtfn_YZWW1lQysVmS4jcECqz9voOrd6EE7QihLKiriQ5Q-cx7gkhggv2Hp3Rmkq2pXKFpttp0Mn5ATrcBHAD7mEc3fCMvcVOp3wMWf_l0oyz-Gw6iMlpbEbXmTHOGGL02kEyLX5xaYd38-jTDjroM7WDHkLyPXzBV1hDNDiY0Yd0gU4tdNF8OO5r9HR78-P6rnh4_HZ_ffVQ6FJIUnDZkloKwnhLadvWVWkaTqRkbVlBLatSm5JWtrSt0I1hwrKGA7O24TbXUrM1ujz0HYP_OZmYVO-iNl0Hg_FTVFxUrBa8_ieYP5lLIasMygOog48xGKvG4PIjZ0WJWrJRe7VEoJYIFptUf7JRr9n68XjH1PSm_Ws8hpGBT0cAoobOBhi0i2_cNncsl4nX6OuBe8kZzP89gLr5fr9U7DecY6vP</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Leal, Alberto J.R.</creator><creator>Monteiro, José P.</creator><creator>Secca, Mário Forjaz</creator><creator>Jordão, Constança</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report</title><author>Leal, Alberto J.R. ; Monteiro, José P. ; Secca, Mário Forjaz ; Jordão, Constança</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4780-68d0987036d11dd954eb60883d45a9854ce415f4fd7cbe37f3b6a3ffb6f7f38c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Anticonvulsants. Antiepileptics. Antiparkinson agents</topic><topic>Biological and medical sciences</topic><topic>BOLD</topic><topic>Brain - blood supply</topic><topic>Brain - pathology</topic><topic>Brain Mapping</topic><topic>Child, Preschool</topic><topic>EEG‐fMRI</topic><topic>Electroencephalography - methods</topic><topic>Epilepsies, Partial - complications</topic><topic>Epilepsies, Partial - pathology</topic><topic>Epilepsy</topic><topic>Functional mapping</topic><topic>Hamartoma - complications</topic><topic>Hamartoma - pathology</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Hypothalamic Diseases - complications</topic><topic>Hypothalamic Diseases - pathology</topic><topic>Hypothalamic hamartoma</topic><topic>Image Processing, Computer-Assisted - methods</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Oxygen - blood</topic><topic>Pharmacology. Drug treatments</topic><topic>Seizure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leal, Alberto J.R.</creatorcontrib><creatorcontrib>Monteiro, José P.</creatorcontrib><creatorcontrib>Secca, Mário Forjaz</creatorcontrib><creatorcontrib>Jordão, Constança</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Epilepsia (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leal, Alberto J.R.</au><au>Monteiro, José P.</au><au>Secca, Mário Forjaz</au><au>Jordão, Constança</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report</atitle><jtitle>Epilepsia (Copenhagen)</jtitle><addtitle>Epilepsia</addtitle><date>2009-06</date><risdate>2009</risdate><volume>50</volume><issue>6</issue><spage>1624</spage><epage>1631</epage><pages>1624-1631</pages><issn>0013-9580</issn><eissn>1528-1167</eissn><coden>EPILAK</coden><abstract>Summary
Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet been demonstrated, owing to the limited spatial–temporal resolution of available functional mapping. We studied a patient with epilepsy associated with HH and gelastic epilepsy. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of several seizure events were obtained, with blood oxygen level dependent (BOLD) activation of the hamartoma, and left hemisphere hypothalamus, hippocampus, parietal–occipital area, cingulate gyrus, and dorsal–lateral frontal area. Integration of regional BOLD kinetics and EEG power dynamics strongly suggests propagation of the epileptic activity from the HH through the left fornix to the temporal lobe, and later through the cingulate fasciculus to the left frontal lobe. The EEG/fMRI method has the spatial–temporal resolution to study the dynamics of seizure activity, with detailed demonstration of origin and propagation pathways.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19183218</pmid><doi>10.1111/j.1528-1167.2008.01810.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences BOLD Brain - blood supply Brain - pathology Brain Mapping Child, Preschool EEG‐fMRI Electroencephalography - methods Epilepsies, Partial - complications Epilepsies, Partial - pathology Epilepsy Functional mapping Hamartoma - complications Hamartoma - pathology Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Hypothalamic Diseases - complications Hypothalamic Diseases - pathology Hypothalamic hamartoma Image Processing, Computer-Assisted - methods Magnetic Resonance Imaging - methods Male Medical sciences Nervous system (semeiology, syndromes) Neurology Neuropharmacology Oxygen - blood Pharmacology. Drug treatments Seizure |
| title | Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report |
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