Presentation
A prolonged period of status epilepticus. Anoxic injury?
Patient Data
Increased T2 signal, best appreciated on FLAIR, involving the cortices of all lobes bilaterally as well as the heads of caudate and lentiform nuclei. With the exception of the basal ganglia, high DWI and low ADC signal, in keeping with diffusion restriction is evident in these areas.
The grey-white matter differentiation is maintained.
The brainstem and cerebellum are normal.
Case Discussion
These MR appearances are typical in appearance and location for the brain during/following a period of status epilepticus. A differential is an anoxic brain injury, however, the exact follow-up status of the patient was not known.
The distribution of the MRI findings and the absence of subcortical or deep grey involvement favors post-seizure appearances rather than an anoxic injury. The absence of edema is also more in favor of the changes relating to recent prolonged seizure activity as opposed to ischemia.
Unable to process the form. Check for errors and try again.