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

Abstract

PurposeRecently, 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. MethodCerebral 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. ResultsEleven 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 1–3s 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. ConclusionIt is feasible to evaluate neurovascular coupling with good temporal correlation in patients with frequent seizure episodes by real-time TCD-vEEG monitoring.