Nonconvulsive status epilepticus in patients with cancer: imaging abnormalities.
BACKGROUND
Convulsive status epilepticus may cause reversible neuroimaging abnormalities. These cortical changes have been reported rarely in association with nonconvulsive status epilepticus.


OBJECTIVE
To describe patients with cancer who had reversible magnetic resonance (MR) imaging abnormalities from nonconvulsive status epilepticus and whose altered mental status and MR imaging findings were initially considered to result from a structural lesion related to their underlying tumor.


METHODS
Retrospective study.


METHODS
Department of Neurology at Memorial Sloan-Kettering Cancer Center, New York, NY.


METHODS
Eight patients with a diagnosis of nonconvulsive status epilepticus who underwent MR imaging.


RESULTS
Enhancing cortical abnormalities were observed on MR images in 4 (50%) of 8 patients with cancer who had impaired mental status and an electroencephalogram demonstrating seizure activity. Follow-up MR images showed neuroimaging improvement or resolution in all patients.


CONCLUSIONS
Cortical enhancement on MR images in patients with cancer who have altered mental status may be due to nonconvulsive status epilepticus and not recurrent or metastatic tumor. If electroencephalography is not immediately available at initial evaluation, a trial of anticonvulsant therapy deserves consideration.
Hormigo
Adília
A
Department of Neurology, Memorial Sloan-Kettering Cancer Center, and Weill Medical College of Cornell University, New York, NY 10021, USA. hormigoa@mskcc.org
Liberato
Bernardo
B
Lis
Eric
E
DeAngelis
Lisa M
LM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005682:Gadolinium / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D014055:Tomography, Emission-Computed / Q000379:methods
D005682:Gadolinium