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Postictal aphasia with transient sulcal hyperintensity on MRI
Ji-Ho Lin1, Shang-Yeong Kwan, Dean Wu
1Department of Neurology, Min-Sheng General Hospital, Taoyuan, Taiwan, R.O.C. epilepsy2000@gmail.com
Journal of the Chinese Medical Association : JCMA
|November 14, 2006
Summary
Transient global aphasia and brain MRI changes after a seizure can resolve quickly. This seizure-induced hyperintensity on MRI may be due to blood flow changes and a temporary blood-brain barrier disruption.
Area of Science:
- Neurology
- Neuroradiology
- Neuroimaging
Background:
- Generalized tonic-clonic seizures can present with diverse neurological deficits.
- Postictal neurological deficits, such as aphasia, are typically transient.
Observation:
- A 38-year-old male experienced global aphasia following a generalized tonic-clonic seizure.
- Magnetic resonance (MR) imaging revealed transient focal hyperintensity in the left frontoparietal sulci on fluid-attenuated inversion recovery (FLAIR) sequences 6 hours post-seizure.
- The observed MR signal abnormality resolved completely within one month.
Findings:
- The transient MR hyperintensity is likely attributed to seizure-induced hyperemia and temporary breakdown of the blood-brain barrier.
- Postictal global aphasia resolved within 24 hours, correlating with the transient nature of the imaging findings.
Implications:
- This case highlights a rare, self-limiting imaging finding following seizures.
- Increased awareness of seizure-induced MR hyperintensity can prevent misdiagnosis and unnecessary interventions.
- Understanding this phenomenon aids in accurate interpretation of neuroimaging in the context of epilepsy.
