PMID- 33487411
OWN - NLM
STAT- MEDLINE
DCOM- 20210729
LR  - 20210729
IS  - 0035-3787 (Print)
IS  - 0035-3787 (Linking)
VI  - 177
IP  - 4
DP  - 2021 Apr
TI  - Will MRI replace the EEG for the diagnosis of nonconvulsive status epilepticus, 
      especially focal?
PG  - 359-369
LID - S0035-3787(20)30745-1 [pii]
LID - 10.1016/j.neurol.2020.09.005 [doi]
AB  - Magnetic resonance imaging (MRI) can now be used to diagnose or to provide 
      confirmation of focal nonconvulsive status epilepticus (NCSE). Approximately half 
      of patients with status epilepticus (SE) have signal changes. MRI can also aid in 
      the differential diagnosis with generalized NCSE when there is a clinical or EEG 
      doubt, e.g. with metabolic/toxic encephalopathies or Creutzfeldt-Jakob disease. 
      With the development of stroke centers, MRI is available 24h/24 in most 
      hospitals. MRI has a higher spatial resolution than electroencephalography (EEG). 
      MRI with hyperintense lesions on FLAIR and DWI provides information related to 
      brain activity over a longer period of time than a standard EEG where only 
      controversial patterns like lateralized periodic discharges (LPDs) may be 
      recorded. MRI may help identify the ictal nature of LPDs. The interpretation of 
      EEG tracings is not easy, with numerous pitfalls and artifacts. Continuous 
      video-EEGs require a specialized neurophysiology unit. The learning curve for MRI 
      is better than for EEG. It is now easy to transfer MRI to a platform with 
      expertise. MRI is more accessible than single photon emission computed tomography 
      (SPECT) or positron emission tomography (PET). For the future, it is more 
      interesting to develop a strategy with MRI than SPECT or PET for the diagnosis of 
      NCSE. With the development of artificial intelligence, MRI has the potential to 
      transform the diagnosis of SE. Additional MRI criteria beyond the classical 
      clinical/EEG criteria of NCSE (rhythmic versus periodic, spatiotemporal evolution 
      of the pattern...) should now be systematically added. However, it is more 
      complicated to move patients to MRI than to perform an EEG in the intensive care 
      unit, and at this time, we do not know how long the signal changes persist after 
      the end of the SE. Studies with MRI at fixed intervals and after SE cessation are 
      necessary.
CI  - Copyright (c) 2021 Elsevier Masson SAS. All rights reserved.
FAU - Gelisse, P
AU  - Gelisse P
AD  - Epilepsy Unit, hopital Gui-de-Chauliac, 80, avenue Fliche, 34295 Montpellier 
      cedex 05, France; Research Unit (URCMA: unite de recherche sur les comportements 
      et mouvements anormaux), INSERM, U661, 34000 Montpellier, France. Electronic 
      address: p-gelisse@chu-montpellier.fr.
FAU - Genton, P
AU  - Genton P
AD  - Centre Saint-Paul-H, Gastaut, Marseille, France.
FAU - Crespel, A
AU  - Crespel A
AD  - Epilepsy Unit, hopital Gui-de-Chauliac, 80, avenue Fliche, 34295 Montpellier 
      cedex 05, France; Research Unit (URCMA: unite de recherche sur les comportements 
      et mouvements anormaux), INSERM, U661, 34000 Montpellier, France.
FAU - Lefevre, P H
AU  - Lefevre PH
AD  - Neuroradiology, hopital Gui-de-Chauliac, Montpellier, France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210122
PL  - France
TA  - Rev Neurol (Paris)
JT  - Revue neurologique
JID - 2984779R
SB  - IM
MH  - Artificial Intelligence
MH  - Electroencephalography
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - *Status Epilepticus
MH  - Tomography, Emission-Computed, Single-Photon
OTO - NOTNLM
OT  - Diagnosis
OT  - EEG
OT  - Lateralized periodic discharges
OT  - MRI
OT  - Nonconvulsive status epilepticus
EDAT- 2021/01/26 06:00
MHDA- 2021/07/30 06:00
CRDT- 2021/01/25 05:30
PHST- 2020/04/09 00:00 [received]
PHST- 2020/08/21 00:00 [revised]
PHST- 2020/09/17 00:00 [accepted]
PHST- 2021/01/26 06:00 [pubmed]
PHST- 2021/07/30 06:00 [medline]
PHST- 2021/01/25 05:30 [entrez]
AID - S0035-3787(20)30745-1 [pii]
AID - 10.1016/j.neurol.2020.09.005 [doi]
PST - ppublish
SO  - Rev Neurol (Paris). 2021 Apr;177(4):359-369. doi: 10.1016/j.neurol.2020.09.005. 
      Epub 2021 Jan 22.