PMID: 15237725Jul 9, 2004Paper

Transient abnormalities associated with status epilepticus on diffusion-weighted MR imaging

Nō to shinkei = Brain and nerve
Ichiro KawaharaHiroaki Yokoyama

Abstract

We report on two patients with transient abnormalities on MRI during status epilepticus(SE). Diffusion-weighted MR imaging(DWI) and T2-weighted and fluid-attenuated inversion recovery (FLAIR) MR images showed cortical and thalamic hyperintensity with swelling of the cortex. The lesions did not respect vascular territories. We also observed an increased signal in the ipsilateral middle cerebral artery on magnetic resonance angiography(MRA), and leptomeningeal enhancement on postcontrast MRI. Follow-up imaging revealed that the abnormal findings resolved within a few weeks, although a residual area of increased T2 signal intensity persisted. These findings suggest the presence of reversible cytotoxic and vasogenic edema induced by seizure. We conclude that this disorder should be taken into consideration in the differential diagnosis of other conditions, including ischemic stroke.

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