Crossed Cerebellar Diaschisis in Status Epilepticus

Samaniego, Edgar A; Stuckert, Erika; Fischbein, Nancy J.; Wijman, Christine A.C.

doi:10.1007/s12028-009-9312-y

Cited by 37 publications

(29 citation statements)

References 8 publications

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“…In the specific subset of CCD cases associated with seizure activity, the underlying pathophysiology is thought to involve a prolonged ictal event that hyperactivates the first order cerebral neurons, causing excitotoxicity and disabling the circuit in a form of transneuronal depression [12].…”

Section: Discussionmentioning

confidence: 99%

“…The first radiographic description was published in 1980, using positron emission tomography (PET) in acute infarct patients [2]. Subsequent reports have described CCD using magnetic resonance imaging (MRI) and characterized the finding in neoplasms, arteriovenous malformations, hemorrhages, and-in conjunction with continuous electroencephalography (cEEG)-have correlated CCD with seizures [9,10,12,13].…”

Section: Introductionmentioning

confidence: 99%

“…In the setting of seizures, CCD is thought to arise from excessive excitatory activity along the cortico-pontine-cerebellar pathways, which produces a similar phenomenon to the deafferentation syndrome observed after acute infarct [9,10,12]. Cases documenting seizure-associated CCD vary considerably in terms of outcome, ranging from full neurologic recovery to permanent disability.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic and Mechanistic Factors Characterizing Seizure-Associated Crossed Cerebellar Diaschisis

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic and Mechanistic Factors Characterizing Seizure-Associated Crossed Cerebellar Diaschisis

et al. 2015

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“…Conventionally, CCD refers to the depression of blood flow and metabolism affecting the cerebellar hemisphere due to a contralateral focal, supratentorial lesion, such as a cerebral infarction or tumor (1, 2). Prolonged seizure activity in SE can uncouple the metabolism and the cerebral blood flow, resulting in tissue hypoxia, anaerobic glycolysis, sodium/potassium pump failure, and cytotoxic edema (3). CCD following SE is caused by excessive neuronal transmission from the prolongation of excitatory synaptic activity via the CPC pathway (3)(4)(5).…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged seizure activity in SE can uncouple the metabolism and the cerebral blood flow, resulting in tissue hypoxia, anaerobic glycolysis, sodium/potassium pump failure, and cytotoxic edema (3). CCD following SE is caused by excessive neuronal transmission from the prolongation of excitatory synaptic activity via the CPC pathway (3)(4)(5). A few cases of CCA after CCD have been reported.…”

Section: Discussionmentioning

confidence: 99%

Crossed Cerebellar Diaschisis in Status Epilepticus

et al. 2016

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Crossed cerebellar diaschisis (CCD) is an interesting phenomenon which classically refers to the depressed blood flow and metabolism affecting one cerebellar hemisphere after a contralateral hemispheric infarction. However, CCD can also be caused by a prolonged seizure. We herein report a case of CCD due to status epilepticus in a patient who showed unique magnetic resonance imaging findings. Case ReportA 67-year-old man with a history of alcoholism was transferred to our hospital with convulsive status epilepticus (SE). Three months earlier, he had caused a traffic accident while driving to the neighboring prefecture and was admitted to the nearest general hospital. He had no apparent traumatic injuries but experienced a single convulsive seizure in the emergency room. He was discharged with a recommendation to consult a physician at his local hospital, which he did not follow.On admission, he presented with repetitive generalized tonic-clonic seizures that first affected the right side of his face and upper right arm. His Glasgow coma scale (GCS) score was E1V2M4. A physical examination revealed that his blood pressure was 112/88 mm Hg, his heart rate was 153 bpm, and his body temperature was 39.4 . Brain computed tomography only revealed mild cerebral atrophy. His blood tests results were as follows: hemoglobin, 17.0 g/dL; white blood cell count, 12,550/mm 3 ; platelets, 132,000/mm 3 ; serum total bilirubin, 2.60 mg/dL; aspartate aminotransferase, 259 IU/L; alanine aminotransferase, 88 IU/L; γ-glutamyl transpeptidase, 1,376 IU/L; creatinine phosphokinase, 976 IU/L; albumin, 3.5 g/L; creatinine, 1.52 mg/dL; and blood urea nitrogen, 17.8 mg/dL. His blood levels of vitamin B1, vitamin B12, and folic acid were normal (4.1 μg/ dL, 670 pg/mL, and 5.1 ng/mL, respectively). A cerebrospinal fluid (CSF) analysis showed a normal cell count and glucose level and a moderately elevated total protein concentration (75 mg/dL, normal range: 10-40 mg/dL). A polymerase chain reaction test for herpes simplex virus in CSF was negative. Artificial ventilation and the intravenous administration of midazolam and fosphenytoin sodium hydrate were initiated, but his convulsive seizure was intractable. Electroencephalography revealed left periodic lateralized epileptiform discharges characterized by rhythmic delta waves over the left frontal, central, and mid-temporal regions (Fig. 1). On brain magnetic resonance imaging (MRI), fluid-attenuated inversion recovery (FLAIR) and diffusionweighted images (DWI) revealed marked hyperintensity and gyral swelling in the cortex of the left hemisphere and the contralateral cerebellum with a corresponding low apparent diffusion coefficient (ADC) (Fig. 2A). Increased flow in the branches of the left middle cerebral artery (MCA) was evident on magnetic resonance angiography (Fig. 3). These findings were consistent with left hemispheric status epilepticus with crossed cerebellar diaschisis (CCD). The DWI

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Autism Spectrum Disorders

Anderson

2018

Developmental Neuropathology

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Crossed Cerebellar Diaschisis in Status Epilepticus

Abstract: This case documents CCD during SE, providing further evidence of contralateral cerebellar involvement with a supratentorial epileptiform focus.

Cited by 37 publications

References 8 publications

Prognostic and Mechanistic Factors Characterizing Seizure-Associated Crossed Cerebellar Diaschisis

Prognostic and Mechanistic Factors Characterizing Seizure-Associated Crossed Cerebellar Diaschisis

Crossed Cerebellar Diaschisis in Status Epilepticus

Autism Spectrum Disorders

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