[PS20-3D-3] Is it the result or cause of Status epilepticus?--Reversible brain MRI abnormalities at 7 hours after seizure onset
[Introduction] Status epilepticus (SE) is an acute neurological emergency with significant mortality and morbidity. The underlying causes were often suggested by brain CT or MRI. However, it is very important to realize that early postictal brain imaging may show abnormalities, which are the consequence of seizure itself rather than its cause.Follow-up MRI studies disclosed that irreversible brain damage can occur in the regions previously affected by SE, they are now better defined as transient periictal MRI abnormalities (TPMA).
[Methods] Case report.
[Results] A 10-year old previous healthy female was admitted 7 h after onset of paresis of the right arm and leg and aphasia, associated with recurrent episodes of tonic-clonic contractions of the right limbs. This patient underwent twice cranial MRI within 7 hours. The original MRI was performed at 1h after the seizure onset,Which demonstrated a low-signal and high-signal focus in the left Frontal-parietal cortex on T1-weighted and T2-weighted imaging respectively. However it showed an amazing result that, at 7h after seizure onset, the abnormal signal on T1 and T2 weighted imaging were almost completely recovered, whereas there was signal decreased in the left frontal-parietal cortex on diffusion weighted images. A follow-up MRI performed1 month later showed a resolution of the abnormal signal in the left frontal-parietal cortex on DWI.MRI performed 6 and 12 months later were normal.
[Conclusion] This case documents TPMA during SE, and review the possible mechanisms, pathophysiology, and clinical implications.
[Methods] Case report.
[Results] A 10-year old previous healthy female was admitted 7 h after onset of paresis of the right arm and leg and aphasia, associated with recurrent episodes of tonic-clonic contractions of the right limbs. This patient underwent twice cranial MRI within 7 hours. The original MRI was performed at 1h after the seizure onset,Which demonstrated a low-signal and high-signal focus in the left Frontal-parietal cortex on T1-weighted and T2-weighted imaging respectively. However it showed an amazing result that, at 7h after seizure onset, the abnormal signal on T1 and T2 weighted imaging were almost completely recovered, whereas there was signal decreased in the left frontal-parietal cortex on diffusion weighted images. A follow-up MRI performed1 month later showed a resolution of the abnormal signal in the left frontal-parietal cortex on DWI.MRI performed 6 and 12 months later were normal.
[Conclusion] This case documents TPMA during SE, and review the possible mechanisms, pathophysiology, and clinical implications.