Abstract Details

Title Hemodynamic Response Associated with Interictal and Ictal Epileptiform Discharges Using Simultaneous Video Electroencephalography (vEEG)/Near Infrared Spectroscopy (NIRS)

Topic Epilepsy

Presentation(s) (-)

Poster/Presentation
Number 005

Objective

Background Simultaneous EEG/NIRS recording is a technique used to monitor both electrical and hemodynamic changes in patients with epilepsy.

Design/Methods This study included 4 children with medically refractory localization-related epilepsy with simultaneous vEEG /NIRS recordings in both hemispheres. We used the hemisphere contralateral to the epileptic focus as an internal control. Multiple seizures or interictal epileptiform discharges were recorded over 24 hours. We used the INVOS NIRS system measuring regional SaO2. The percentage changes in NIRS were calculated at prior to, during, and after epileptiform discharges or seizures.

Results Patient #1 had multiple electroclinical seizures. Patient #2 had focal cortical dysplasia and multiple tonic seizures. Patient #3 had a normal brain MRI and hemispheric electrical status epilepticus of slow-wave sleep. Patient #4 had focal cortical malformation and frequent focal interictal spikes. Patients #1 and #2 had known regional hypometabolism on PET over the seizure focus, and showed baseline interictal hypoperfusion (20% decrease) in NIRS over the affected hemisphere as compared with the contralateral hemisphere. Patient #3 had relative hemispheric NIRS hyperperfusion during sleep, corresponding to the continuous hemispheric discharges. rSO2 increased during the pre-ictal (5%), ictal (10%), and post-ictal periods (13-18%) compared to baseline. The hemodynamic changes were also detected in the control hemisphere during postictal stage (5%).

Conclusions This study showed clear hemodynamic responses associated with epileptiform discharges, including ictal and interictal epileptiform discharges. The hemodynamic changes observed in NIRS could potentially be used in detecting seizures or increased epileptiform activity. Key words: vEEG/NIRS, hemodynamic response, epileptiform discharges , epilepsy.

Authors/Disclosures
Harry T. Whelan, MD (Medical College of Wisconsin) PRESENTER	No disclosure on file
Xiuhua L. Bozarth, MD (Seattle Children'S Hospital, Child Neurology)	No disclosure on file
Priya A. Monrad, MD (Seattle Children's Hospital)	No disclosure on file
Daniel Weintraub	Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Clintrex. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scion. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Modality.ai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CuraSen. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Takeda. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorder Society. The institution of Daniel Weintraub has received research support from NIH. The institution of Daniel Weintraub has received research support from Fox Foundation. The institution of Daniel Weintraub has received research support from IPMDS. Daniel Weintraub has received intellectual property interests from a discovery or technology relating to health care.
Kurt E. Hecox, MD	No disclosure on file
	No disclosure on file

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