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Acute cerebral microbleeds in refractory status epilepticus

Sang-Beom Jeon1, Gunjan Parikh, H Alex Choi

  • 1Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.

Epilepsia
|February 13, 2013
PubMed

Insights

New cerebral microbleeds (CMBs) may acutely develop in patients experiencing refractory status epilepticus (SE). This finding is novel, as CMBs were previously unreported in SE cases.

Area of Science:

  • Neurology
  • Neuroimaging
  • Critical Care Medicine

Background:

  • Cerebral microbleeds (CMBs) are associated with stroke and cerebral amyloid angiopathy.
  • CMBs have not been previously reported in patients with status epilepticus (SE).

Observation:

  • Two previously healthy patients presented with refractory SE of unknown origin.
  • Initial neuroimaging revealed no evidence of CMBs in either patient.
  • Follow-up susceptibility-weighted imaging showed the acute development of numerous CMBs (63 and 14) in the two patients.

Findings:

  • Refractory SE is associated with the potential for acute development of multiple CMBs.
  • Multimodal neuromonitoring indicated significant physiological disturbances, including altered brain metabolism and impaired cerebrovascular regulation.

Implications:

  • This study highlights a potential novel complication of refractory SE.
  • Further research is warranted to understand the mechanisms and clinical significance of CMBs in SE.
  • These findings may influence diagnostic and management strategies for patients with refractory SE.

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