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Unilateral or bilateral punctate hippocampal hyperintensities on DW-MRI: seizures, amnesia, or both?

Jone Bocos-Portillo1, Inés Escalza-Cortina1, Marian Gómez-Beldarrain1

  • 1Departmenf of Neurology, Hospital de Galdakao-Usansolo, 48960, Galdakao, Vizcaya, Spain.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|June 4, 2018
PubMed

Insights

Small punctate lesions in the hippocampus on diffusion-weighted MRI can indicate different conditions. This finding may suggest a potential link between transient global amnesia and seizures, warranting further investigation.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Small hippocampal hyperintense lesions on diffusion-weighted (DW) MRI present diagnostic challenges due to varied etiologies.
  • Accurate diagnosis is crucial as therapeutic approaches differ significantly based on the underlying cause.

Observation:

  • Three patients presented with similar punctate hippocampal lesions on DW MRI sequences.
  • The patients exhibited distinct clinical presentations: isolated amnesia (transient global amnesia), amnesia with seizures, and seizures alone.

Findings:

  • Hippocampal punctate lesions were observed following transient global amnesia.
  • The same radiological pattern was also present in patients experiencing seizures, including focal-onset and generalized seizures.

Implications:

  • The shared MRI pattern suggests a possible pathogenic link between transient global amnesia and seizures.
  • Further research is needed to explore this potential connection and its clinical significance.
Keywords:
HippocampusMagnetic resonance imagingPunctate lesionsSeizuresTransient global amnesia

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