Transient Occipitotemporal Subcortical Diffusion-Weighted Magnetic Resonance Imaging Abnormalities Associated With Status Epilepticus-Case Report-

Abstract

A 30-year-old man presented with a generalized seizure manifesting as decreased consciousness. Diffusion-weighted magnetic resonance imaging showed transient areas of high intensity in the gray and subcortical white matter of the left occipital and temporal lobes. The lesions did not reflect the vascular territories. After a period of over 2 weeks, his consciousness level improved associated with reduced intensity of the abnormal areas. These findings suggest that seizure induced reversible cytotoxic and vasogenic edema. Transient diffusion-weighted magnetic resonance imaging abnormalities may be associated with generalized seizures and the intensity may reflect the clinical condition.

Pathophysiology and Long‐Term Outcome of Reversible Tumor‐Like Lesions Induced by Presenting Status Epilepticus

“…In our cases with generalized tonic‐clonic seizures, and especially in patient 2, the probable cause of SE favors the first hypothesis. Interestingly, a careful review of the literature discloses that the patients with primarily generalized SE have transitory MRI signal changes mostly located in regions irrigated by the posterior cerebral arterial circulation: occipital, parieto‐occipital, and temporo‐occipital 2,24,26 . Based on this finding, we admit that the lower sympathetic innervation of the posterior circulation may contribute to a greater susceptibility of these regions to the hyperperfusion that occurs during SE in a similar way to the cerebral lesions observed in the reversible posterior leukoencephalopathy syndrome with which the transitory lesions induced by SE share similar pathophysiologic mechanisms and MRI signal abnormalities 27,28 …”

An exploration of the spectrum of peri -ictal MRI change; a comprehensive literature review

“…However several useful trends do emerge. The type and extent of ictal related oedema appears to have some bearing on the potential for full resolution or development of longstanding sequelae [29,126]. Though the rule is by no means absolute acute changes mainly due to cytotoxic oedema are more likely to persist [19,20,64] whereas lesions associated with vasogenic oedema are potentially more likely to be at least in part reversible [5,16,30,54].…”

Acute Ischemic Cerebrovascular Disease Clinical and Imaging Findings in an Epileptic Case

“…ADC değişiklikleri hipoksi veya serebral iskemi ile değil, hücre ölümü sonucu gelişir. [1,4,5,[12][13][14][15] Nöbet geçiren hastalarda da genel olarak beklenen sitotoksik ödemin etkisine bağlı olarak ADC haritasında hiperintensite görülmesidir. Bazı epilepsi çalışmalarında difüzyon ağırlıklı görüntüleme çalışmasında kronik epilepsi olgularında peri-iktal difüzyon ağırlıklı görüntülerde sinyal artışı ve ADC'de sinyal yoğun-luğunda yükselme gösterdiğini bildirilmiştir.…”