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Postictal subcortical restricted diffusion in a child with focal symptomatic epilepsy
Kenneth A Myers1, Mehmet S Albayram2, Aleksandra Mineyko1
1Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Pediatric Neurology
|May 21, 2014
Summary
This case study highlights a rare instance of acute encephalopathy with biphasic seizures and late reduced diffusion (AESRD) in a non-East Asian child. The findings emphasize the importance of considering AESRD in diverse populations presenting with specific MRI diffusion abnormalities post-seizure.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroradiology
Background:
- Diffusion abnormalities on MRI are common after prolonged seizures.
- Isolated, focal, subcortical restricted diffusion is an uncommon finding.
Observation:
- A 6-year-old girl of Kurdish descent with a history of focal-onset epilepsy experienced status epilepticus during a febrile illness.
- Neurological deterioration, including posturing and irritability, was noted 4 days after the seizure.
- Brain MRI revealed left hemisphere subcortical restricted diffusion, primarily in frontal and occipital regions.
Findings:
- The patient developed persistent right hemiparesis for 2 months.
- The presentation mimicked acute encephalopathy with biphasic seizures and late reduced diffusion (AESRD).
- This case represents a rare occurrence of AESRD in a non-East Asian individual.
Implications:
- This case expands the known demographic of AESRD.
- It underscores the need for broader recognition of AESRD beyond East Asian populations.
- Highlights the diagnostic value of MRI in identifying specific diffusion patterns in encephalopathy.