Cerebrovascular disease burden in late-onset non-lesional focal epilepsy

This study aimed to evaluate the burden of leukoaraiosis, a marker of cerebral SVD, and hippocampal atrophy in patients with late-onset epilepsy (LOE).MethodsBrain magnetic resonance imaging (MRI) studies were retrospectively analyzed by two blinded radiologists. The Fazekas and Scheltens scales were used to assess the degree of leukoaraiosis and hippocampal atrophy in 33 patients with non-lesional LOE, 41 patients with clinical signs of SVD (eg, recent history of transient ischemic attack [TIA] or lacunar stroke), and 26 healthy controls, all>60 years of age.ResultsMean age in epilepsy patients was 70.9 (±6.6) years; 57.6% were men. The history of vascular risk factors was similar in all groups. Median (interquartile range) Fazekas score was 1 (0-1) in the epilepsy group, 1 (0-2) in TIA/lacunar stroke patients, and 0 (0-1) in the healthy group. Degree of leukoaraiosis was milder in epilepsy patients compared to the TIA/lacunar stroke group (p = 0.004), and similar to that of healthy controls (p = 0.593). Hippocampal atrophy was significantly greater in patients with epilepsy (p 
Source: Seizure - Category: Neurology Source Type: research

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Differential diagnosis between acute ischemic stroke (AIS) and epilepsy-related stroke mimics is sometimes difficult in the emergency department. We investigated whether a combination of diffusion-weighted imaging (DWI) and arterial spin labeling imaging (ASL) is useful in distinguishing AIS from epileptic disorders.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
ConclusionSeizures, young age, cortical lesions, and multiple infarction at the time of stroke are independent risk factors for PSE in children following a first-ever AIS.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
CONCLUSION: Seizures, young age, cortical lesions, and multiple infarction at the time of stroke are independent risk factors for PSE in children following a first-ever AIS. PMID: 30253308 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
ConclusionNot every diffuse restriction observed on MRI indicates an ischemic stroke. Although radiologic images of the splenium may suggest acute ischemic infarction, the actual cause may be another pathology. Therefore, the symptoms and aetiologies of patients with splenium lesions should be considered and investigated from a wide range of perspectives.
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
Summary ObjectiveEndovascular therapy has recently become standard therapy for select patients with acute ischemic stroke. Infarcted brain tissue may undergo hemorrhagic transformation (HT) after endovascular therapy. We investigated the association between HT and occurrence of poststroke seizures in patients treated with endovascular therapy. MethodsConsecutive patients treated with endovascular therapy for acute anterior circulation ischemic stroke were included. HT was assessed with computed tomography/magnetic resonance imaging (CT/MRI) at 24 h after stroke onset. Patients were followed for up to 2 years for seizure oc...
Source: Epilepsia - Category: Neurology Authors: Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research
We report on three cases in which these symptoms were caused by thalamic ischemia. Two patients presented with stereotypically recurring hemiparesthesias lasting 2 –5 min that gradually spread from the face to the arm and leg on one side. A first cerebral magnetic resonance imaging including DWI was negative in both cases, whereas new thalamic infarctions appeared on repeated imaging when clinical symptoms remained. A third case with a thalamic ischemia did not show recurring events, but also presented with purely sensory spreading symptoms. In all three cases EEG and cardiovascular diagnostics revealed normal r...
Source: Journal of Neurology - Category: Neurology Source Type: research
Conclusions:CADASIL is the most prevalent monogenic cerebral small-vessel arteriopathy. Despite wide availability of genetic testing, misdiagnosis and delay diagnosis are common. We encourage for enhanced awareness of CADASIL among patients with migraines with aura, recurrent TIAs or subcortical ischemic strokes, and mood disorder, in order to provide appropriate multidisciplinary treatment, psychological support and genetic counselingStudy Supported by: n/aDisclosure: Dr. Ortiz-Garcia has nothing to disclose. Dr. Orjuela has nothing to disclose. Dr. Sweis has nothing to disclose. Dr. Biller has received personal compensat...
Source: Neurology - Category: Neurology Authors: Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research
Conclusion CVST results in more frequent and early seizures whereas in arterial stroke late seizures are common. Post stroke seizures in ischemic stroke were predicted by carotid territory infarction and venous stroke by parenchymal involvement.
Source: International Journal of Epilepsy - Category: Neurology Source Type: research
See Sun et al. (doi:10.1093/aww306) for a scientific commentary on this article. About 20% of patients with ischaemic stroke have a preceding transient ischaemic attack, which is clinically defined as focal neurological symptoms of ischaemic origin resolving spontaneously. Failure to diagnose transient ischaemic attack is a wasted opportunity to prevent recurrent disabling stroke. Unfortunately, diagnosis can be difficult, due to numerous mimics, and to the absence of a specific test. New diagnostic tools are thus needed, in particular for radiologically silent cases, which correspond to the recommended tissue-based defini...
Source: Brain - Category: Neurology Authors: Tags: CNS Injury and Stroke Original Articles Source Type: research
Publication date: Available online 10 November 2016 Source:Mitochondrion Author(s): Charalampos Tzoulis, Eilen Henriksen, Hrvoje Miletic, Laurence A. Bindoff Stroke-like lesions are characteristically associated with mitochondrial encephalopathies such as those caused by mutations of polymerase gamma (POLG) and the m.3243A>G mitochondrial DNA (mtDNA) mutation. The combination of acute clinical onset, MRI and pathological abnormalities, have led to the suggestion that these lesions are ischemic. Here, we sought to determine the role of ischemia in the pathogenesis of mitochondrial stroke-like lesions. We performed a sys...
Source: Mitochondrion - Category: Biochemistry Source Type: research
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