Peri-ictal magnetic resonance imaging characteristics in dogs with suspected idiopathic epilepsy

Background The pathophysiology of changes in magnetic resonance imaging (MRI) detected after a seizure is not fully understood. Objective To characterize and describe seizure-induced changes detected by MRI. Animals Eighty-one client-owned dogs diagnosed with idiopathic epilepsy. Methods Data collected retrospectively from medical records and included anatomical areas affected, T1-, T2-weighted and T2-FLAIR (fluid-attenuated inversion recovery) appearance, whether changes were unilateral or bilateral, symmetry, contrast enhancement, mass effect, and, gray and white matter distribution. Diffusion- and perfusion weighted maps were evaluated, if available. Results Seizure-induced changes were T2-hyperintense with no suppression of signal on FLAIR. Lesions were T1-isointense (55/81) or hypointense (26/81), local mass effect (23/81) and contrast enhancement (12/81). The majority of changes were bilateral (71/81) and symmetrical (69/71). The most common areas affected were the hippocampus (39/81) cingulate gyrus (33/81), hippocampus and piriform lobes (32/81). Distribution analysis suggested concurrence between cingulate gyrus and pulvinar thalamic nuclei, the cingulate gyrus and parahippocampal gyrus, hippocampus and piriform lobe, and, hippocampus and parahippocampal gyrus. Diffusion (DWI) characteristics were a mixed-pattern of restricted, facilitated, and normal diffusion. Perfusion (PWI) showed either hypoperfusion (6/9) or hyperperfusion (3/9). Conclusions and Clinical Importance More areas, than previously reported, have been identified that could incur seizure-induced changes. Similar to human literature, DWI and PWI changes have been identified that could reflect the underlying metabolic and vascular changes.

Automated summary

Seizure-induced changes detected by MRI in dogs include T2 hyperintensity, T1 isointense or hypointense lesions, local mass effect, and contrast enhancement, with a majority being bilateral and symmetrical. The study identified areas such as the hippocampus, cingulate gyrus, and piriform lobes, as well as DWI and PWI changes that may reflect metabolic and vascular alterations.