[Reversible bilateral cortical MRI changes as sequelae of status epilepticus].
Neuroimaging may detect structural and functional changes following seizures. Magnetic resonance imaging (MRI) studies showed increased signal intensities in T2- and diffusion-weighted images, especially in the temporal cortex. We report a patient with reversible symmetrical signal abnormalities of the insular cortex after seizures. In addition, the frontal paramedian cortex and the central region were involved. There was no leptomeningeal or parenchymal enhancement on contrast-enhanced T1-weighted images, suggesting an intact blood-brain barrier. Upon follow-up examination 12 days later, the signal abnormalities resolved completely. Reversible hyperintensities on T2-weighted images are due to different causes leading to increased water content, such as demyelinisation or edema. According to published data, cytotoxic edema caused by excessive glutamate concentration and other noxious substances is assumed to be the most probable cause for these findings.
Weidauer
S
S
Institut für Neuroradiologie, Klinikum der Johann Wolfgang Goethe-Universität, Schleusenweg 2-16, 60528 Frankfurt. Weidauer@em.uni-frankfurt.de
Krakow
K
K
Lanfermann
H
H
Zanella
F E
FE
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000175:diagnosis*; D001929:Brain Edema / Q000175:diagnosis; D002540:Cerebral Cortex / Q000473:pathology*; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D012075:Remission, Spontaneous; D013226:Status Epilepticus / Q000175:diagnosis*; D013702:Temporal Lobe / Q000473:pathology