TABLE 2.
Summary of neuroimaging studies of the postictal state (2001‐2019)
| Result | Technique | Population | Reference |
|---|---|---|---|
| Hippocampal atrophy | T1‐ and T2‐weighted MR images | Intractable focal epilepsy with impaired awareness | Olejniczak et al (2001) 82 |
| Deactivation default mode network | SPECT | Epilepsy with spontaneous secondarily generalized tonic‐clonic seizures | Blumenfeld et al (2009) 83 |
| Dysregulated cerebral blood flow | |||
| Hypoperfusion (lateral temporal lobe, hippocampus) | SPECT, ASL ‐MRI, PWI, CT | Temporal lobe epilepsy, focal epilepsy | Koepp et al (2010) 10 , Farrell et al (2016) 88 , Gaxiola‐Valdez et al (2017) 85 , Li et al (2019) 84 |
| Hyperperfusion (parahippocampal gyrus) | PWI | (Extra‐) temporal lobe epilepsy | Leonhardt et al (2005) 89 |
| Hyperperfusion (right temporal lobe, basal ganglia) | SPECT | Epilepsy after encephalitis (during postictal psychosis) | Yasumoto et al (2015) 87 |
| Hyperperfusion (left parahippocampal gyrus, bilateral fusiform gyri, left middle temporal gyrus) | ASL | Idiopathic epilepsy | Chen et al (2016) 90 |
| Dysregulated diffusion | |||
| Decreased diffusion around seizure foci | DWI | Focal status epilepticus | Koepp et al (2010) 10 |
| Increased diffusion in underlying white matter | |||
Abbreviations: ASL‐MRI, Arterial spin labelling magnetic resonance imaging; CT, computed tomography; DWI, diffusion‐weighted imaging; MR, magnetic resonance; PWI, pefusion‐weighted imaging; SPECT, single photon emission computed tomography.