Status epilepticus

Case contributed by Sepehr Haghighi
Diagnosis almost certain

Presentation

Referred to hospital with status epilepticus

Patient Data

Age: 3 years
Gender: Female
mri

Increased T2W/FLAIR signal intensity at both parietal lobes, right frontal lobe, both insula and also thalami as well as restriction in DWI sequence. Cerebral cortex and subcortical regions are involved. ADC signal at these regions is not completely dropped.

Case Discussion

These findings are related to post-status epilepticus changes in the brain parenchyma in a patient with a seizure disorder. The most common changes seen are an increased T2 signal (best seen on FLAIR), that may demonstrate corresponding diffusion abnormalities, with increased DWI signal and in some instances reduced ADC values 1.

The locations involved are variable, including 2,3:

  • cerebral cortex and subcortical white matter
  • hippocampi and mesial temporal lobes
  • thalamus, particularly the pulvinar region

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