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[Transient abnormalities associated with status epilepticus on diffusion-weighted MR imaging].

Ichiro Kawahara1, Keisuke Tsutsumi, Makoto Hirose

  • 1Department of Neurosurgery, Nagasaki Rousai Hospital.

No to Shinkei = Brain and Nerve
|July 9, 2004
PubMed
Summary

Transient MRI abnormalities during status epilepticus (SE) in two patients suggest reversible edema. These seizure-induced changes, including cortical swelling, can mimic ischemic stroke on imaging.

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Area of Science:

  • Neurology
  • Neuroradiology
  • Neuroimaging

Background:

  • Status epilepticus (SE) is a neurological emergency.
  • Accurate diagnosis of SE is critical for timely treatment.
  • MRI plays a crucial role in evaluating SE and its complications.

Observation:

  • Two patients with SE exhibited transient MRI abnormalities.
  • Findings included cortical and thalamic hyperintensity and swelling.
  • Lesions did not follow vascular territories.

Findings:

  • Diffusion-weighted imaging (DWI), T2-weighted, and FLAIR MRI showed abnormalities.
  • Magnetic resonance angiography (MRA) revealed increased signal in the middle cerebral artery.
  • Leptomeningeal enhancement was observed on postcontrast MRI.

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  • Abnormalities resolved within weeks, with residual T2 signal changes.

    • Implications:

    • Findings suggest reversible cytotoxic and vasogenic edema due to seizures.
    • These transient MRI findings can mimic ischemic stroke.
    • Consider SE-induced reversible changes in the differential diagnosis of acute brain imaging findings.