INTRODUCTION: Transient neuroimaging findings associated with seizure activity have received relatively little attention in the neurosurgical literature. These abnormalities may mimick neoplastic or ischemic changes on magnetic resonance imaging (MRI), possibly leading to additional studies and surgical treatment. CASE DESCRIPTION: A 17-year-old right-handed male was transferred to emergency room in status epilepticus. A MRI obtained 5 months before admission was negative. On the day of admission, he had multiple intermittent upper-left extremity partial seizures and prolonged secondary generalized seizures. An electroencephalogram (EEG) showed frequent epileptiform discharges over the right hemisphere posteriorly. A MRI study performed 2 days after admission revealed non-hemorrhagic abnormalities involving the right occipital region that were hyperintense on fluid-attenuated inversion recovery (FLAIR) and T2 weighted sequences. The apparent diffusion coefficient map was unremarkable. Follow-up MRIs, 3 and 11 months after admission, showed complete resolution of these lesions. CONCLUSION: Imaging findings after status epilepticus may raise suspicion of ischemic or neoplastic lesions. These findings may be reversible. Further follow-up imaging may prevent unnecessary intervention.
INTRODUCTION: Transient neuroimaging findings associated with seizure activity have received relatively little attention in the neurosurgical literature. These abnormalities may mimick neoplastic or ischemic changes on magnetic resonance imaging (MRI), possibly leading to additional studies and surgical treatment. CASE DESCRIPTION: A 17-year-old right-handed male was transferred to emergency room in status epilepticus. A MRI obtained 5 months before admission was negative. On the day of admission, he had multiple intermittent upper-left extremity partial seizures and prolonged secondary generalized seizures. An electroencephalogram (EEG) showed frequent epileptiform discharges over the right hemisphere posteriorly. A MRI study performed 2 days after admission revealed non-hemorrhagic abnormalities involving the right occipital region that were hyperintense on fluid-attenuated inversion recovery (FLAIR) and T2 weighted sequences. The apparent diffusion coefficient map was unremarkable. Follow-up MRIs, 3 and 11 months after admission, showed complete resolution of these lesions. CONCLUSION: Imaging findings after status epilepticus may raise suspicion of ischemic or neoplastic lesions. These findings may be reversible. Further follow-up imaging may prevent unnecessary intervention.
Authors: Irena Balzekas; Vladimir Sladky; Petr Nejedly; Benjamin H Brinkmann; Daniel Crepeau; Filip Mivalt; Nicholas M Gregg; Tal Pal Attia; Victoria S Marks; Lydia Wheeler; Tori E Riccelli; Jeffrey P Staab; Brian Nils Lundstrom; Kai J Miller; Jamie Van Gompel; Vaclav Kremen; Paul E Croarkin; Gregory A Worrell Journal: Front Hum Neurosci Date: 2021-07-26 Impact factor: 3.473
Authors: Michael L Bell; Satish Rao; Elson L So; Max Trenerry; Noojan Kazemi; S Matt Stead; Gregory Cascino; Richard Marsh; Fredric B Meyer; Robert E Watson; Caterina Giannini; Gregory A Worrell Journal: Epilepsia Date: 2009-04-06 Impact factor: 5.864
Authors: D F Black; J M Morris; E P Lindell; K N Krecke; G A Worrell; J D Bartleson; D H Lachance Journal: AJNR Am J Neuroradiol Date: 2013-06-20 Impact factor: 3.825