Yong-Woo Kim MD, Abstract Co-Author: Nothing to Disclose

Hwaseong Ryu, Presenter: Nothing to Disclose

Seung-Kug Baik MD, Abstract Co-Author: Nothing to Disclose

Jae-Yeon Hwang MD, Abstract Co-Author: Nothing to Disclose

Jeong A Yeom, Abstract Co-Author: Nothing to Disclose

Jin Hyeok Kim MD, Abstract Co-Author: Nothing to Disclose

Yun-Jin Lee MD, Abstract Co-Author: Nothing to Disclose

To evaluate the relationship between cortical perfusion or venous flow and electrographic activity in the children with seizure using susceptibility weighted imaging (SWI) and electroencephalogrphy (EEG). 

Children presenting with seizures who underwent MRI-SWI and EEG within 24 hours of seizure onset were retrospectively reviewed. The localized area of increased cortical venous flow (SWI+) was assessed using SWI while the abnormal activities such as slowing or epileptiform discharges (EEG+) were investigated on EEG recordings. We defined three groups of patients according to the correlation between MRI-SWI and EEG: (A) no increased venous flow and no abnormal discharges, (B) discordant finding between the SWI+ and EEG+ area, (C) concordant finding between the SWI+ and EEG+ area. 

We identified 297 children (194 in group-A, 76 in group-B, and 27 in group-C). The mean age among the three groups was similar (group-A: 3.8±4.6, group-B: 5.0±4.5, group-C: 4.6±4.8 years). The greatest difference among these groups was in seizure frequency and underlying disease. Multiple seizures were revealed more frequently in group-C (12/27, 44.4%) than in group-A (47/194, 24.2%, p=0.026) or group-B (18/76, 23.7%, p=0.041). The incidence of newly-diagnosed epilepsy was significantly higher in group-C (14/27, 51.9%) than in group-A (59/194, 30.4%, p=0.026) or group-B (22/76, 28.9%, p=0.032). By contrast, there were no significant differences in the previous seizure history, seizure types or duration among the three groups.   

Seizures with concordant findings between increased venous flow on MRI-SWI and abnormal electrographic activities are more likely to more frequent or real epileptic seizures. 

Susceptibility-Weighted image is well represented cortical venous flow in children with seizure and helpful to show the change of cortical blood flow in frequent seizure.

Kim, Y, Ryu, H, Baik, S, Hwang, J, Yeom, J, Kim, J, Lee, Y, Relation to Cortical Blood Flow and Electrographic Activity in Childhood-onset Seizures: Correlation between MRI-SWI and EEG.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008411.html