Emergency multimodal computed tomography for the diagnosis of stroke mimic--epileptic seizure
- Author:
Xiaowei Hu
;
Shicun Huang
;
Ziwei Lu
;
Feirong Yao
;
Yiqing Wang
;
Yeting Lu
;
Xiangyi Zhu
;
Min Xu
;
Qi Fang
- Publication Type:Journal Article
- Keywords:
Multimodal CT;
epileptic seizure;
stroke mimics;
differential diagnosis
- From:Neurology Asia
2020;25(3):269-277
- CountryMalaysia
- Language:English
-
Abstract:
Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms
but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke
mimic. The purpose of this study is to investigate the application of emergency multimodal computed
tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case
group of patients with suspected stroke in the emergency stroke care service of the First Affiliated
Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent
multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were
ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke
were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was
completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in
four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow
and cerebral blood volume were significantly increased, while time to peak and mean transit time
decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group.
Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure
from stroke.
- Full text:7.2020my0042.pdf
