Real-time-TCD-vEEG monitoring for neurovascular coupling in  epilepsy

Yuan  Yao 1, Qiang Lu 1, Li-Ri Jin, Xiang-Qin Zhou, Yan Huang, Wei-Hai Xu *

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan 1, Dong Cheng District, Beijing 100730, China

A B S  T R A C T

Purpose: Recently, a novel multi-model monitor has been available, which integrates real-time signals of transcranial Doppler (TCD) and video-EEG (vEEG) into one workstation. We  sought to test the feasibility of this device in  detecting neurovascular coupling in  patients with epilepsy.

Method: Cerebral blood flow velocity (CBFV)  of  bilateral middle cerebral arteries and vEEG  during seizure episodes were recorded simultaneously in 12  patients (age 17–58 years) with partial epilepsies. The  correlations between vEEG and CBFV findings were analyzed.

Results: Eleven seizure episodes were detected  in  5  patients. Of  them, bilateral CBFV increase with interhemispheric  asymmetry was observed in  4  seizure episodes of  3  patients. EEG  abnormalities preceded CBFV increase by  1–3 s at the onset of a seizure. In  a patient with bilateral middle cerebral artery stenosis, no apparent CBFV changes were detected during 2 of 3 seizure episodes. Another patient with previous frontal hemorrhage displayed CBFV increase without interhemispheric asymmetry during

4 seizure episodes.

Conclusion:  It is feasible to evaluate neurovascular coupling with good temporal correlation in patients with frequent seizure episodes by  real-time TCD-vEEG  monitoring.

2015 British Epilepsy Association. Published by  Elsevier Ltd.  All rights reserved

1.  Introduction

It is known that epileptic discharges can  evoke an  increase of cerebral blood flow to  meet the high metabolic demands due to intense neuronal activities. Such  neurovascular coupling can  be detected by the combination of electroencephalography (EEG) and transcranial Doppler (TCD). In previous studies, the signals of TCD and  EEG  were  recorded  by   separate  devices  during  seizure episodes and correlated off-line [1,2].   Given the inconvenience of  detection, only patients with very high frequency of  seizure episodes (up  to  60  times per  day) or  inducible seizures (such as absence seizures) were studied. Recently, a  novel multi-model monitor has  been available, which integrates real-time signals of TCD and video-EEG (vEEG) into one workstation (NSD-8100, Delica China). In current study, we  sought to  test the feasibility of this device in evaluating epilepsy patients in routine clinical setting.

 Real-time TCD-vEEG monitoring for neurovascular coupling in epilepsy.pdf