Pulvinar sign in status epilepticus

Case contributed by Paloma Martínez Sebastiá
Diagnosis almost certain

Presentation

Hospitalized patient with acute onset of generalized seizure.

Patient Data

Age: 75 years
Gender: Male

Hyperintensity in T2 and FLAIR sequences and restricted diffusion of left medial occipital cortex and bilateral and symmetric restricted diffusion of the dorsal region of both thalamus (pulvinar nuclei). These findings are consistent with status epilepticus.

Case Discussion

Pulvinar sign in status epilepticus is a rare radiological finding, more frequently appearing in Creutzfeldt-Jakob disease (CJD) and variant Creutzfeldt–Jakob disease (vCJD). Once our patient recovered, both nuclei and occipital cortex became less hyperintense, confirming status epilepticus as the cause of these radiological findings.

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