Your browser version may not work well with NCBI's Web applications. More information here...
1: Clin Neurophysiol. 2008 Sep;119(9):1973-84. Epub 2008 Jul 14.
Related Articles, Links
Click here to read Click here to read
Association of seizures with cortical spreading depression and peri-infarct depolarisations in the acutely injured human brain.

Fabricius M, Fuhr S, Willumsen L, Dreier JP, Bhatia R, Boutelle MG, Hartings JA, Bullock R, Strong AJ, Lauritzen M.

Department of Clinical Neurophysiology, Glostrup Hospital, Nordre Ringvej, 2600 Glostrup, Denmark. fabricius@dadlnet.dk

OBJECTIVE: To test the co-occurrence and interrelation of ictal activity and cortical spreading depressions (CSDs) - including the related periinfarct depolarisations in acute brain injury caused by trauma, and spontaneous subarachnoid and/or intracerebral haemorrhage. METHODS: 63 patients underwent craniotomy and electrocorticographic (ECoG) recordings were taken near foci of damaged cortical tissue for up to 10 days. RESULTS: 32 of 63 patients exhibited CSDs (5-75 episodes) and 11 had ECoGraphic seizure activity (1-81 episodes). Occurrence of seizures was significantly associated with CSD, as 10 of 11 patients with seizures also had CSD (p=0.007, 2-tailed Fishers exact test). Clinically overt seizures were only observed in one patient. Each patient with CSD and seizures displayed one of four different patterns of interaction between CSD and seizures. In four patients CSD was immediately preceded by prolonged seizure activity. In three patients the two phenomena were separated in time: multiple CSDs were replaced by ictal activity. In one patient seizures appeared to trigger repeated CSDs at the adjacent electrode. In 2 patients ongoing repeated seizures were interrupted each time CSD occurred. CONCLUSIONS: Seizure activity occurs in association with CSD in the injured human brain. SIGNIFICANCE: ECoG recordings in brain injury patients provide insight into pathophysiological mechanisms, which are not accessible by scalp EEG recordings.

Publication Types:
PMID: 18621582 [PubMed - indexed for MEDLINE]

PMCID: PMC2573967 [Available on 2009/09/01]