Referred to hospital with status epilepticus
Loading Stack -
0 images remaining
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.
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
- 1. Walker M. Status epilepticus: an evidence based guide. (2005) BMJ (Clinical research ed.). 331 (7518): 673-7. doi:10.1136/bmj.331.7518.673 - Pubmed
- 2. Kim JA, Chung JI, Yoon PH, Kim DI, Chung TS, Kim EJ, Jeong EK. Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. (2001) AJNR. American journal of neuroradiology. 22 (6): 1149-60. Pubmed
- 3. Angelos M. Katramados, David Burdette, Suresh C. Patel, Lonni R. Schultz, Shailaja Gaddam, Panayiotis D. Mitsias. Periictal diffusion abnormalities of the thalamus in partial status epilepticus. (2009) Epilepsia. 50 (2): 265. doi:10.1111/j.1528-1167.2008.01736.x - Pubmed