Transient postictal magnetic resonance imaging abnormality of the corpus callosum in a patient with epilepsy. Case report and review of the literature.
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.
Cohen-Gadol
Aaron A
AA
Department of Neurologic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. cohengadol.aaron@mayo.edu
Britton
Jeftrey W
JW
Jack
Clifford R
CR
Friedman
Jonathan A
JA
Marsh
W Richard
WR
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