[Cerebral lesions following convulsive partial status epilepticus. Clinical, neuroradiologic and PET study of a case].
An 11-year-old girl developed signs of intracranial hypertension after status epilepticus with convulsive movements of her right upper limb. Computerized tomography revealed left hemispheric hypodensity with mass effect, attributed to vasogenic edema. Intracranial hypertension was controlled under intracranial pressure monitoring and clinical status slowly improved. The patient was aphasic and right hemiplegic when she recovered consciousness but she remarkably recovered from her neurological deficits during the following two years despite neuroradiological evolution demonstrating extensive destruction of the left cortex and white matter. Two positron emission tomography (PET) scans were performed respectively six weeks and eight months after status epilepticus, and both demonstrated profound left hemispheric hypometabolism except in the lenticular nucleus and a restricted area of motor/premotor cortex. On the other hand, glucose metabolism in the right hemisphere was heterogeneously increased on the second PET when compared with the first PET. We concluded that, in this case, clinical recovery might have implicated functional reorganization arising from the intact hemisphere.
Van Bogaert
P
P
Départament de Neurologie (Neurologie pédiatrique), Hôpital Erasme, Université Libre de Bruxelles, Belgique.
Goldman
S
S
Rodesch
G
G
Deleval
J
J
Luxen
A
A
Stanus
E
E
Balériaux
D
D
Szliwowski
H B
HB
D001037:Aphasia / Q000175:diagnosis; D001927:Brain Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D001929:Brain Edema / Q000000981:diagnostic imaging; D002648:Child; D003342:Corpus Striatum / Q000378:metabolism; D003952:Diagnostic Imaging; D004828:Epilepsies, Partial / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D006429:Hemiplegia / Q000175:diagnosis; D006801:Humans; D009044:Motor Cortex / Q000378:metabolism; D011559:Pseudotumor Cerebri / Q000175:diagnosis; D012640:Seizures / Q000175:diagnosis; D013226:Status Epilepticus / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D005947:Glucose