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Recurrent Occipital Seizures with Transient MRI Changes
Mohankumar Kurukumbi1,2, Allison Jacobs1,2
1Department of Neurology, Inova Fairfax Hospital, Falls Church, VA, USA.
Abstract:
Peri-ictal magnetic resonance imaging (MRI) findings following seizure activity are a recognized phenomenon that is not well understood (Cole, 2004). Transient changes are not usually expected to be present in postictal MRI studies because of their rarity. Here, we present a unique case of peri-ictal MRI findings located in the occipital lobe, present in a 34-year-old female with recurrent occipital seizures occurring twice in four years. MRI changes completely resolved after both episodes with no residual focal damage. The peri-ictal occipital changes on MRI in this patient are unique because they have been captured on more than one occasion. Peri-ictal MRI findings are a known phenomenon with unknown pathophysiology, although attempts have been made to understand these findings. Though the MRI findings and presentation appear to be stroke-like or PRES-like, seizures should be kept in the differential for better treatment outcomes.
Insights
Transient MRI changes in the occipital lobe following seizures are rare but can occur. This case highlights unique, reversible peri-ictal MRI findings in a patient with recurrent occipital seizures.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Peri-ictal magnetic resonance imaging (MRI) findings post-seizure are recognized but poorly understood.
- Transient MRI changes are uncommon in postictal studies due to their rarity.
Observation:
- A unique case of peri-ictal MRI findings in the occipital lobe is presented.
- The patient is a 34-year-old female with recurrent occipital seizures (twice in four years).
Findings:
- MRI changes were observed in the occipital lobe following seizure activity.
- These changes completely resolved after both seizure episodes, with no residual focal damage.
- The peri-ictal occipital MRI changes were captured on more than one occasion, making this case unique.
Implications:
- Peri-ictal MRI findings, though rare, can mimic stroke or PRES (Posterior Reversible Encephalopathy Syndrome).
- Seizures should be considered in the differential diagnosis for such findings to ensure appropriate treatment.
- Further research into the pathophysiology of peri-ictal MRI changes is warranted.
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