Related Experiment Videos
Reversible MRI lesions after seizures
C Aykut-Bingol1, S Tekin, D Ince
1Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey.
Abstract:
After generalized or partial seizures, transient lesions may appear on magnetic resonance (MR) images. The mechanisms of MR changes might be a defect in cerebral autoregulation and blood-brain permeability. We report a patient with partial and secondary generalized tonic-clonic seizures. After her first seizure which was generalized tonic-clonic in nature, we detected multiple high signal intensities over the frontal cortical area on proton density images which were enhanced with gadolinium on T1-weighted images. The first and repeated EEGs showed no abnormalities or epileptic discharges. We started carbamezapine (600 mg/d) and excluded systemic diseases like vasculitis, infections, aetiological factors causing cerebrovascular diseases. In the follow-up, she was seizure free under antiepileptic therapy and no other neurological deficit. Repeated MR scans after 24 months from her first seizure revealed no pathologic signal intensities. Although the pathophysiology is unknown, recognition of reversible lesions helps diagnostic and therapeutic approaches to abnormal MR findings after seizures.
Insights
Transient MRI lesions after seizures can resolve over time. Recognizing these reversible changes is crucial for accurate diagnosis and treatment of post-seizure magnetic resonance imaging abnormalities.
Area of Science:
- Neurology
- Neuroradiology
Background:
- Seizures, both generalized and partial, can be associated with transient magnetic resonance (MR) imaging abnormalities.
- Potential mechanisms include impaired cerebral autoregulation and blood-brain barrier permeability.
Observation:
- A patient presented with partial and secondary generalized tonic-clonic seizures.
- Initial MR imaging revealed frontal cortical high signal intensities, with gadolinium enhancement on T1-weighted images, despite normal electroencephalograms (EEGs).
Findings:
- The patient was treated with carbamazepine and other potential causes were excluded.
- Follow-up MR scans after 24 months showed complete resolution of the lesions, with no recurrence of seizures or neurological deficits.
Implications:
- This case highlights the reversibility of certain MR imaging lesions following seizures.
- Awareness of these transient findings aids in the diagnostic and therapeutic management of patients with abnormal post-seizure MR scans.