Neuroimaging Correlates of Periodic Discharges. Issue 4 (July 2018)

• Record Type: Journal Article
• Authors: Herlopian, Aline; Struck, Aaron F.; Rosenthal, Eric; Westover, Brandon M.
• Is Part Of: Journal of clinical neurophysiology. Volume 35:Issue 4(2018)
• Publication Date: 2018-07
• Subjects: Periodic discharges -- Neuroimaging -- SPECT -- PET -- MRI; Electroencephalography -- Periodicals; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electroencephalography; Periodicals; 612.805
• DOI: 10.1097/WNP.0000000000000466
• Languages: English
• ISSNs: 0736-0258

Abstract

Abstract : Summary: Despite being first described over 50 years ago, periodic discharges continue to generate controversy as to whether they are always, sometimes, or never "ictal." Investigators and clinicians have proposed adjunctive markers to help clarify this distinction—in particular measures of perfusion and metabolism. Here, we review the growing number of neuroimaging studies using Fluorodeoxyglucose-PET, MRI diffusion, Magnetic resonance perfusion, Single Photon Emission Computed Tomography, and Magnetoencepgalography to gain further insight into the physiology and clinical significance of periodic discharges. To date, however, no definitive consensus exists regarding the features of periodic discharges that warrant treatment intensification. However, an emerging consilience among neuroimaging modalities suggests that periodic discharges can induce a hyperexcitatory state with associated hypermetabolism and hyperperfusion, which may result in local metabolic failure.