title: Transient postictal magnetic resonance imaging abnormality of the corpus callosum in a patient with epilepsy. Case report and review of the literature.
abstract: Transient neuroimaging abnormalities associated with seizure activity have received little attention in the literature. The authors report a focal magnetic resonance (MR) imaging abnormality of the corpus callosum in a patient following a secondary generalized seizure. A 27-year-old right-handed man presented with a history of medically refractory partial seizures since the age of 1 year. The results of an MR imaging study obtained 4 months prior to the patient undergoing video-electroencephalography monitoring were unremarkable. After the patient discontinued all antiepileptic medications, a secondary generalized seizure of right temporal origin was recorded. Five days later, repeated MR imaging revealed a nonenhancing 14 x 11-mm ovoid hyperintense lesion in the splenium of corpus callosum. The patient was asymptomatic, and his neurological and neurocognitive examinations remained unremarkable. Follow-up MR imaging 5 weeks and 1 year later demonstrated near-complete resolution of the lesion. Benign and transient abnormalities in the splenium can occur as a periictal phenomenon. A high index of suspicion and follow-up imaging may prevent further unwarranted intervention.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. cohengadol.aaron@mayo.edu
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
authors.forename: Jeftrey W
authors.initials: JW
authors.lastname: Britton
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Friedman
authors.forename: W Richard
authors.initials: WR
authors.lastname: Marsh
mesh_terms: D000328:Adult; D061085:Agenesis of Corpus Callosum; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000473:pathology*; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon