Reverse crossed cerebellar diaschisis in status epilepticus: case report

Abstract

A 53-year-old female with history of ischemic stroke eleven years before was admitted to the emergency room with recurrent few seconds duration head turning seizures in the past two weeks. Electroencephalogram confirmed focal status epilepticus and Brain MRI disclosed restricted diffusion over left hemisphere regions, together with signs of reverse crossed cerebellar diaschisis (Figure 1). Diaschisis is a transient neuronal shock modality attributable to depression of distant parts of the brain, connected to an injured area 1. In focal status epilepticus, cerebellar injury is hypothesized to be due to an excessive excitatory neuronal transmission in the cortico-pontine-cerebellar tract 2 .