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The medial pulvinar as a subcortical relay in temporal lobe status epilepticus


Capecchi, Francesco; Mothersill, Ian; Imbach, Lukas L (2020). The medial pulvinar as a subcortical relay in temporal lobe status epilepticus. Seizure, 81:276-279.

Abstract

PURPOSE

Mutual cortico-thalamic interactions are assumed to be the basis for sustained ictal activity during status epilepticus. We aimed to investigate thalamic involvement during focal status epilepticus through the analysis of ictal diffusion-weighted MR-imaging.

METHODS

We retrospectively analyzed a cohort of 62 patients who received an MRI scan during an episode of focal onset status epilepticus in our center between 2001 and 2018.

RESULTS

Thalamic diffusion restrictions during focal status epilepticus were found in 29 of 62 cases (46.8 %). As the most frequent localization, the medial pulvinar was affected in 22 cases (75.9 %). Temporal status epilepticus was associated with thalamic DWI-findings (20/33, 60.6 %), in particular in the medial pulvinar (18/33, 54.5 %). To the contrary, the medial pulvinar was less frequently involved in parietal (3/11, 27.3 %) and only rarely in frontal status epilepticus (1/15, 6.7 %).

CONCLUSION

The medial pulvinar appears to be a frequently involved subcortical relay for maintenance of ictal activity in temporal onset focal status epilepticus. Our findings provide possible novel insights regarding the interpretation of thalamic DWI restrictions in patients with unclear neurological conditions.

Abstract

PURPOSE

Mutual cortico-thalamic interactions are assumed to be the basis for sustained ictal activity during status epilepticus. We aimed to investigate thalamic involvement during focal status epilepticus through the analysis of ictal diffusion-weighted MR-imaging.

METHODS

We retrospectively analyzed a cohort of 62 patients who received an MRI scan during an episode of focal onset status epilepticus in our center between 2001 and 2018.

RESULTS

Thalamic diffusion restrictions during focal status epilepticus were found in 29 of 62 cases (46.8 %). As the most frequent localization, the medial pulvinar was affected in 22 cases (75.9 %). Temporal status epilepticus was associated with thalamic DWI-findings (20/33, 60.6 %), in particular in the medial pulvinar (18/33, 54.5 %). To the contrary, the medial pulvinar was less frequently involved in parietal (3/11, 27.3 %) and only rarely in frontal status epilepticus (1/15, 6.7 %).

CONCLUSION

The medial pulvinar appears to be a frequently involved subcortical relay for maintenance of ictal activity in temporal onset focal status epilepticus. Our findings provide possible novel insights regarding the interpretation of thalamic DWI restrictions in patients with unclear neurological conditions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Neurology
Health Sciences > Neurology (clinical)
Language:English
Date:October 2020
Deposited On:23 Dec 2020 15:49
Last Modified:24 Dec 2020 21:00
Publisher:Elsevier
ISSN:1059-1311
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.seizure.2020.08.016
PubMed ID:32919252

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