Marta Drake-Pérez1, Enrique Marco de Lucas2, John Lyo3, José L Fernández-Torre4. 1. Department of Radiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain; Biomedical Research Institute (IDIVAL), Santander, Spain. Electronic address: drake.marta@gmail.com. 2. Department of Radiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain; Biomedical Research Institute (IDIVAL), Santander, Spain. 3. Department of Neuroradiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Clinical Neurophysiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain; Department of Physiology and Pharmacology, University of Cantabria (UNICAN), Santander, Cantabria, Spain.
Abstract
PURPOSE: To describe the neuroimaging findings in subacute encephalopathy with seizures in alcoholics (SESA syndrome). METHODS: We reviewed all cases reported previously, as well as 4 patients diagnosed in our center. We included a total of 8 patients. All subjects had clinical and EEG findings compatible with SESA syndrome and at least one MRI study that did not show other underlying condition that could be responsible for the clinical presentation. RESULTS: Initial MRI studies revealed the following features: cortical-subcortical areas of increased T2/FLAIR signal and restricted diffusion (6 patients), hyperperfusion (3 patients), atrophy (5 patients), chronic microvascular ischemic changes (4 patients). Follow-up MRI was performed in half of the patients, all showing a resolution of the hyperintense lesions, but developing focal atrophic changes in 75%. CONCLUSIONS: SESA syndrome should be included among the alcohol-related encephalopathies. Its radiological features include transient cortical-subcortical T2-hyperintense areas with restricted diffusion (overlapping the typical findings in status epilepticus) observed in a patient with atrophy and chronic multifocal vascular lesions.
PURPOSE: To describe the neuroimaging findings in subacute encephalopathy with seizures in alcoholics (SESA syndrome). METHODS: We reviewed all cases reported previously, as well as 4 patients diagnosed in our center. We included a total of 8 patients. All subjects had clinical and EEG findings compatible with SESA syndrome and at least one MRI study that did not show other underlying condition that could be responsible for the clinical presentation. RESULTS: Initial MRI studies revealed the following features: cortical-subcortical areas of increased T2/FLAIR signal and restricted diffusion (6 patients), hyperperfusion (3 patients), atrophy (5 patients), chronic microvascular ischemic changes (4 patients). Follow-up MRI was performed in half of the patients, all showing a resolution of the hyperintense lesions, but developing focal atrophic changes in 75%. CONCLUSIONS: SESA syndrome should be included among the alcohol-related encephalopathies. Its radiological features include transient cortical-subcortical T2-hyperintense areas with restricted diffusion (overlapping the typical findings in status epilepticus) observed in a patient with atrophy and chronic multifocal vascular lesions.
Authors: José L Fernández-Torre; Ignacio Banzo; Fernando Ortega-Valín; Ernesto Orozco-Sevilla; Isabel Martínez-Rodríguez; Enrique Marco de Lucas Journal: J Neurol Date: 2018-08-18 Impact factor: 4.849