Vertigo and dizziness are extremely common complaints, related to either peripheral or central nervous system disorders. Among the latter, epilepsy has to be taken into consideration: indeed, vertigo may be part of the initial aura of a focal epileptic seizure in association with other signs/symptoms, or represent the only ictal manifestation, a rare phenomenon known as "vertiginous" or "vestibular" seizure. These ictal symptoms are usually related to a discharge arising from/involving temporal or parietal areas, which are supposed to be a crucial component of the so-called "vestibular cortex". In this paper, we describe three patients suffering from drug-resistant focal epilepsy, symptomatic of malformations of cortical development or perinatal hypoxic/ischemic lesions located in the posterior regions, who presented clusters of vertiginous seizures. The high recurrence rate of such events, recorded during video-EEG monitoring sessions, offered the opportunity to perform an ictal EEG/fMRI study to identify seizure-related hemodynamic changes. The ictal EEG/fMRI revealed the main activation clusters in the temporo-parieto-occipital regions, which are widely recognized to be involved in the processing of vestibular information. Interestingly, ictal deactivation was also detected in the ipsilateral cerebellar hemisphere, suggesting the ictal involvement of cortical-subcortical structures known to be part of the vestibular integration network.

Ictal EEG/fMRI study of vertiginous seizures / Morano, Alessandra; Carnì, Marco; Casciato, Sara; Vaudano, Anna Elisabetta; Fattouch, Jinane; Fanella, Martina; Albini, Mariarita; Basili, Luca Manfredi; Lucignani, Giulia; Scapeccia, Marco; Tomassi, Regina; Di Castro, Elisabetta; Colonnese, Claudio; Giallonardo, Anna Teresa; Di Bonaventura, Carlo. - In: EPILEPSY & BEHAVIOR. - ISSN 1525-5050. - ELETTRONICO. - 68:(2017), pp. 51-56. [10.1016/j.yebeh.2016.12.031]

Ictal EEG/fMRI study of vertiginous seizures

Morano, Alessandra;Carnì, Marco;Casciato, Sara;Vaudano, Anna Elisabetta;Fattouch, Jinane;Fanella, Martina;Albini, Mariarita;Basili, Luca Manfredi;Lucignani, Giulia;Scapeccia, Marco;Di Castro, Elisabetta;Colonnese, Claudio;Giallonardo, Anna Teresa;Di Bonaventura, Carlo
2017

Abstract

Vertigo and dizziness are extremely common complaints, related to either peripheral or central nervous system disorders. Among the latter, epilepsy has to be taken into consideration: indeed, vertigo may be part of the initial aura of a focal epileptic seizure in association with other signs/symptoms, or represent the only ictal manifestation, a rare phenomenon known as "vertiginous" or "vestibular" seizure. These ictal symptoms are usually related to a discharge arising from/involving temporal or parietal areas, which are supposed to be a crucial component of the so-called "vestibular cortex". In this paper, we describe three patients suffering from drug-resistant focal epilepsy, symptomatic of malformations of cortical development or perinatal hypoxic/ischemic lesions located in the posterior regions, who presented clusters of vertiginous seizures. The high recurrence rate of such events, recorded during video-EEG monitoring sessions, offered the opportunity to perform an ictal EEG/fMRI study to identify seizure-related hemodynamic changes. The ictal EEG/fMRI revealed the main activation clusters in the temporo-parieto-occipital regions, which are widely recognized to be involved in the processing of vestibular information. Interestingly, ictal deactivation was also detected in the ipsilateral cerebellar hemisphere, suggesting the ictal involvement of cortical-subcortical structures known to be part of the vestibular integration network.
2017
Cerebellum; EEG/fMRI; Epilepsy; MCD; Vertigo; Adult; Cerebral Cortex; Female; Humans; Middle Aged; Seizures; Electroencephalography; Magnetic Resonance Imaging; Neurology; Neurology (clinical); Behavioral Neuroscience
01 Pubblicazione su rivista::01a Articolo in rivista
Ictal EEG/fMRI study of vertiginous seizures / Morano, Alessandra; Carnì, Marco; Casciato, Sara; Vaudano, Anna Elisabetta; Fattouch, Jinane; Fanella, Martina; Albini, Mariarita; Basili, Luca Manfredi; Lucignani, Giulia; Scapeccia, Marco; Tomassi, Regina; Di Castro, Elisabetta; Colonnese, Claudio; Giallonardo, Anna Teresa; Di Bonaventura, Carlo. - In: EPILEPSY & BEHAVIOR. - ISSN 1525-5050. - ELETTRONICO. - 68:(2017), pp. 51-56. [10.1016/j.yebeh.2016.12.031]
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