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Related Experiment Videos

Diffusion changes suggesting predominant vasogenic oedema during partial status epilepticus.

Keun-Sik Hong1, Yong-Jin Cho, Sang Kun Lee

  • 1Department of Neurology, Ilsan Paik Hospital, Inje University, 2240 Daewha-dong, Ilsan-gu, Goyang-city, Gyonggi-do 411-706, South Korea. nrhks@ilsanpaik.ac.kr

Seizure
|May 26, 2004
PubMed
Summary

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Partial status epilepticus (PSE) can present with variable diffusion-weighted imaging (DWI) findings. Vasogenic edema, not just cytotoxic edema, may dominate DWI during PSE, impacting diagnosis.

Area of Science:

  • Neurology
  • Neuroradiology
  • Neuroimaging

Background:

  • Partial status epilepticus (PSE) is a challenging neurological condition.
  • Diffusion-weighted imaging (DWI) is crucial for detecting cytotoxic edema in epilepsy.
  • The role of vasogenic edema in DWI during PSE requires further elucidation.

Observation:

  • A case of PSE with aphasia, hemiparesis, and focal motor seizures was studied.
  • T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) maps revealed vasogenic edema in the left temporo-parietal region during PSE.
  • Electroencephalography (EEG) confirmed ictal activity, and single-photon emission tomography (SPECT) showed hyperperfusion.

Findings:

  • DWI findings in PSE can be variable, reflecting either cytotoxic or vasogenic edema.

Related Experiment Videos

  • Vasogenic edema, associated with blood-brain barrier breakdown, can be a predominant DWI finding during PSE.
  • Follow-up imaging showed resolution of edema but revealed cortical atrophy and white matter changes.

    • Implications:

    • Understanding the spectrum of DWI findings in PSE is critical for accurate diagnosis.
    • DWI interpretation in PSE should consider the potential for vasogenic edema alongside cytotoxic edema.
    • Long-term consequences like atrophy and white matter changes may follow PSE episodes.