Focal cerebral magnetic resonance changes associated with partial status epilepticus.
We report 2 patients with transient abnormalities on magnetic resonance imaging (MRI) associated with partial status epilepticus (SE). A man with a 4-month history of partial seizures had complex partial SE for 9 days, with left temporal maximum on ictal EEG. Left temporal lobe T2 signal was increased on MRI during SE, but cerebral MRI was normal 9 weeks later. A woman with "cryptogenic" temporal lobe epilepsy for 16 years had complex partial SE for 1 week, with right temporal maximum on ictal EEG. T2 Signal was increased over the entire right temporal lobe, extending into the insula, without mass effect, on MRI 1 month after SE ended. Repeat MRI 1 month later showed marked decrease in volume of increased T2 intensity, without gadolinium enhancement, but with mild mass effect over the right anterioinferomesial temporal areas. A gemistocytic astrocytoma was resected. Focal cerebral MRI abnormalities consistent with cerebral edema may be due to partial SE but also may indicate underlying glioma, even in long-standing partial epilepsy. Focal structural imaging changes consistent with neoplasm should be followed to full resolution after partial SE.
Henry
T R
TR
Department of Neurology, University of Michigan Medical Center, Ann Arbor.
Drury
I
I
Brunberg
J A
JA
Pennell
P B
PB
McKeever
P E
PE
Beydoun
A
A
D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis / Q000473:pathology; D001921:Brain / Q000473:pathology*; D001929:Brain Edema / Q000175:diagnosis / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology; D004828:Epilepsies, Partial / Q000175:diagnosis*; D017029:Epilepsy, Complex Partial / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013226:Status Epilepticus / Q000175:diagnosis*; D013702:Temporal Lobe / Q000473:pathology