Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Dıskapı, 06110, Ankara, Turkey.
Acta Neurol Belg. 2021 Feb;121(1):211-217. doi: 10.1007/s13760-019-01202-7. Epub 2019 Aug 27.
To identify the relationship between thalamic volume and electrical status epilepticus in sleep (ESES). We analyzed subcortical gray matter volumes in patients with an ESES pattern on their electroencephalographs. All magnetic resonance imaging scans were considered within normal limits. The patients were not receiving antiepileptic drug at the time of the MRI study. High resolution T1-weighted 3-dimensional MPRAGE scans were assessed for segmentation and quantitative volumetric analysis of the brain by using the "volBrain" method. After correcting for total brain volume, volumes were compared with a group of healthy controls (HCs) and patients with benign childhood epilepsy with centrotemporal spikes (BECTS). Fifteen patients with ESES, 15 patients with BECTS, and 30 HCs were included. The median age of the patients with ESES was 8.5 (range, 5.8-13) years, 8 (range, 5-14) years for the HCs, and 7.8 (range, 4-13.5) years for the patients with BECTS. The total relative thalamic volume was significantly lower in patients with ESES than in the healthy controls (0.87 ± 0.07 vs. 0.93 ± 0.03, p = 0.002), and in patients with ESES than in those with BECTS (0.87 ± 0.07 vs. 0.93 ± 0.03, p = 0.006). There was no significant difference the HCs and patients with BECTS (0.93 ± 0.03 vs. 0.93 ± 0.03, p = 0.999). Both right and left relative thalamic volumes were lower in patients with ESES than in HCs (right thalamus: 0.43 ± 0.04 vs. 0.46 ± 0.02, p = 0.003, left thalamus: 0.44 ± 0.03 vs. 0.47 ± 0.02, p = 0.002), in patients with ESES than in patients with BECTS (right thalamus: 0.43 ± 0.04 vs. 0.46 ± 0.01, p = 0.01, left thalamus: 0.43 ± 0.04 vs. 0.47 ± 0.01, p = 0.007); however, there was no significant difference between the HCs and patients with BECTS (right thalamus: 0.46 ± 0.02 vs. 0.46 ± 0.01, p = 0.999, left thalamus: 0.47 ± 0.02 vs. 0.47 ± 0.01, p = 0.999). This study highlights the association between thalamic involvement and ESES, even when not severe enough to cause a detectable lesion on visual interpretation of MRI.
为了确定丘脑体积与睡眠中癫痫样电活动（ESES）之间的关系。我们分析了脑电图上出现 ESES 模式的患者的皮质下灰质体积。所有磁共振成像扫描均被认为在正常范围内。在进行 MRI 研究时，患者未服用抗癫痫药物。使用“volBrain”方法对高分辨率 T1 加权 3 维 MPRAGE 扫描进行分割和定量体积分析。在对总脑体积进行校正后，将体积与一组健康对照组（HCs）和良性儿童癫痫伴中央颞区棘波（BECTS）患者进行比较。纳入了 15 例 ESES 患者、15 例 BECTS 患者和 30 例 HCs。ESES 患者的中位年龄为 8.5 岁（范围，5.8-13 岁），HCs 为 8 岁（范围，5-14 岁），BECTS 患者为 7.8 岁（范围，4-13.5 岁）。ESES 患者的总丘脑相对体积明显低于健康对照组（0.87±0.07 比 0.93±0.03，p=0.002），也明显低于 BECTS 患者（0.87±0.07 比 0.93±0.03，p=0.006）。HCs 和 BECTS 患者之间的丘脑相对体积无显著差异（0.93±0.03 比 0.93±0.03，p=0.999）。ESES 患者的右侧和左侧丘脑相对体积均低于 HCs（右侧丘脑：0.43±0.04 比 0.46±0.02，p=0.003，左侧丘脑：0.44±0.03 比 0.47±0.02，p=0.002），也低于 BECTS 患者（右侧丘脑：0.43±0.04 比 0.46±0.01，p=0.01，左侧丘脑：0.43±0.04 比 0.47±0.01，p=0.007）；然而，HCs 和 BECTS 患者之间的丘脑相对体积无显著差异（右侧丘脑：0.46±0.02 比 0.46±0.01，p=0.999，左侧丘脑：0.47±0.02 比 0.47±0.01，p=0.999）。这项研究强调了丘脑受累与 ESES 之间的关联，即使在视觉解释 MRI 时不足以引起可检测到的病变。
