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

Universitaire Ziekenhuizen KU Leuven

Status: Enrolling

Conditions: Status Epilepticus; Perfusion Weighted MRI; Ictal-interictal Continuum; Perfusion CT; Positron-emission Tomography

Treatments: Diagnostic Test: MRI scan including arterial spin labelling of the brain; Diagnostic Test: FDG-PET scan of the brain; Diagnostic Test: CT perfusion scan of the brain

Study type: Interventional

Funder types: Other

Identifiers

NCT06017973

S67933

Details and patient eligibility

About

The investigators propose a prospective study of 20 control subjects and 180 consecutive patients with possible non-convulsive status epilepticus (NCSE). The investigators will obtain three functional images of the brain:

1. Fluorodeoxyglucose positron emission tomography (FDG-PET)
2. Perfusion (and structural) magnetic resonance (MR) images
3. Computed tomography (CT) perfusion.

Brain hypermetabolism/hyperperfusion is a strong argument to confirm a diagnosis of non-convulsive status epilepticus.

The aim is to determine which of the three functional imaging techniques is the most sensitive and easy to obtain in the detection of hypermetabolism/hyperperfusion. The investigators will determine which EEG patterns are associated with hypermetabolism/perfusion.

The investigators will further study and describe the management with antiseizure medication and outcome of the group with possible non-convulsive status epilepticus WITH hypermetabolism/hyperperfusion versus the group with possible non-convulsive status epilpticus WITHOUT hypermetabolism/hyperperfusion.

The investigators will make recommendations for an imaging protocol in possible NCSE for widespread use. The aim is to offer guidelines to incorporate imaging in the diagnosis, management and prognosis of NCSE in patients with the ictal-interictal continuum.

Enrollment: 200 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• The patient has possible non-convulsive status epilepticus with scalp or invasive EEG with ictal-interictal continuum patterns on EEG

Exclusion criteria

• The patient has a contra-indication for MRI such as metal implants
• The patient has contrast sensitivity
• The patiensuffers from claustrophobia or cannot tolerate confinement during PET-MRI scanning procedures

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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200 participants in 2 patient groups

Possible non-convulsive status epilepticus with ictal-interictal continuum EEG patterns

Other group

Description:

Patients with a possible non-convulsive status epilepticus, according to American Clinical Neurophysiology Criteria (ACNS) (2021).

Treatment:

Diagnostic Test: CT perfusion scan of the brain

Diagnostic Test: FDG-PET scan of the brain

Diagnostic Test: MRI scan including arterial spin labelling of the brain

Healthy control subjects

Other group

Description:

Healthy control subjects.

Treatment:

Diagnostic Test: CT perfusion scan of the brain

Diagnostic Test: FDG-PET scan of the brain

Diagnostic Test: MRI scan including arterial spin labelling of the brain