The Role of Brain Imaging in Diagnosing and Managing Possible Non-convulsive Status Epilepticus A Prospective Study Comparing MRI, CT Perfusion, and FDG-PET in Patients with Ictal-Interictal EEG Patterns

What this Trial Is About

Researchers are evaluating different brain imaging methods to improve the diagnosis, management, and outcome prediction of possible non-convulsive status epilepticus (NCSE). This study involves 20 control subjects and 180 patients with possible NCSE and aims to identify which of three functional imaging techniques—FDG-PET, MR perfusion, or CT perfusion—is most sensitive and practical for detecting brain hypermetabolism or hyperperfusion, which strongly supports NCSE diagnosis. The study also explores EEG patterns linked to these brain changes and compares treatment outcomes between patients with and without hypermetabolism or hyperperfusion. Participants will undergo three types of brain scans: an FDG-PET scan on a GE Signa 3T PET-MR scanner to assess focal hypermetabolism using standardized uptake values; an MRI scan including arterial spin labeling, T2-weighted FLAIR, T1-weighted, and diffusion-weighted imaging sequences; and a CT perfusion scan using the Siemens Naeotom Alpha with photon-counting technology. These imaging procedures occur on Day 1 to detect brain activity and blood flow changes related to NCSE. During the study, researchers will assess the sensitivity of each imaging technique on Day 1 and analyze correlations between EEG ictal-interictal patterns and PET scan uptake values. They will also monitor seizure freedom within 24 hours after the FDG-PET scan. The study includes 180 patients with possible NCSE and 20 control subjects, and findings will guide recommendations for imaging protocols to support diagnosis, management, and prognosis of NCSE in clinical practice.

The Role of Imaging in the Diagnosis, Management and Prognosis of Possible Non-convulsive Status Epilepticus