Cerebral Blood Flow During Spike‐Wave Discharges

Summary We used the 133xenon method to assess cerebral blood flow (CBF) during generalized spike‐wave discharges in a patient with an uncommon form of generalized epilepsy with persistent spike‐wave discharges. CBF measurements were made under four conditions with repeated measures: normal EEG, continuous theta state, continuous spike‐wave state at rest, and continuous spike‐wave discharges during performance of a cognitive activation task. CBF was mildly reduced (5.7%) during the theta state and decreased further (12%) in the spikewave state. Although globally diminished, CBF was less decreased in the frontal lobes and more decreased in the parietal lobes during spike‐wave discharges. CBF increased to baseline levels during the cognitive activation task. The decrease in CBF suggested that the generalized spike‐wave discharges caused a net decrease in cortical metabolic demand and neuronal activity. The differences in lobar CBF during spike‐wave discharges may reflect lobar disparities in neuronal firing patterns. The theta state noted is novel and intermediate between normal and spike‐wave.

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