Transcranial brain parenchyma sonography in patients with juvenile myoclonic epilepsy

• Published in: Acta neurologica Belgica Vol. 124; no. 4; pp. 1335 - 1342
• Main Authors: Djordjević, Ivana, Djordjević, Stefan, Kosać, Ana, Vučinić, Dragana, Ivanović Radović, Nelica, Ždraljević, Mirjana, Mijajlović, Milija
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2024
• Subjects: Biomedical and Life Sciences; Biomedicine; Medicine/Public Health; Neurology; Neuroradiology; Neurosciences; Basal ganglia; Red nucleus; Juvenile myoclonic epilepsy; Transcranial brain parenchyma sonography; Substantia nigra
• ISSN: 0300-9009; 2240-2993; 2240-2993
• DOI: 10.1007/s13760-024-02561-6

Introduction
There are rising evidences that subcortical structures, including the basal ganglia, are affected in patients with epilepsy. These structures are thought to influence the modulation and phenotypic expression of epileptic seizures. Our study aimed to evaluate the presence of structural abnormalities in subcortical structures in patients with juvenile myoclonic epilepsy (JME).
Methods
This cross-sectional study included 51 patients who were diagnosed with JME and who were monitored on an outpatient basis at the Clinic for Neurology and Psychiatry for Children and Youth in Belgrade from January 1985 to October 2017. All patients underwent transcranial parenchymal sonography (TCS) from October 2015 to October 2017. Relation of clinical parameters (seizure control andcognitive functioning,) with TCS results was assessed.
Results
Hyperechogenicity of the substantia nigra (SN) was detected in 37.2% of JME subjects and it was significantly more common in patients with JME than in the control group. The marked echogenicity of the red nucleus (RN) was detected in 17.6% of cases, while 11.8% of subjects had hyperechogenic RN. The presence of hyperechogenic RN (both right and left) was significantly more frequent in the group of patients with JME compared to the control group. The third ventricle diameter was larger in patients with JME than in controls.
Conclusion
Structural changes of certain subcortical structures, primarily SN and RN, detected in JME patients indicate additional non-lesional abnormalities of the basal ganglia and midbrain structures in these patients.