title: Periictal magnetic resonance imaging in status epilepticus.
abstract: OBJECTIVE
  To determine the changes of magnetic resonance imaging (MRI) during the periictal phase in status epilepticus (SE).
  
  
  METHODS
  We identified 15 patients diagnosed of status epilepticus with corresponding MRI changes, including 11 patients with generalized convulsive status epilepticus (GCSE), 2 with complex partial status epilepticus (CPSE), and 2 with simple partial status epilepticus (SPSE). All MRI changes, corresponding electroencephalogram, and prognosis were evaluated.
  
  
  RESULTS
  Regional cortical lesions were observed on MRI, including restricted diffusion in diffusion-weighted images (DWIs) (11 out of 15) and hyperintense signal change in fluid-attenuated inversion recovery (FLAIR) images (12 out of 15) with hypervascularity and parenchymal swelling. The remote lesions included crossed cerebellar diaschisis (3 patients), ipsilateral thalamic lesion (4 patients), and basal ganglia lesions (3 patients). Although the periictal MRI changes were usually reversible, irreversible changes were also found, especially in GCSE, such as focal brain atrophy, cortical laminar necrosis, and mesial temporal sclerosis. GCSE patients with periodic epileptic form discharges had higher possibilities of widespread MRI abnormalities and poor prognosis in the future.
  
  
  CONCLUSIONS
  In this study, DWIs and FLAIR images were proved useful in determining the extent and severity of early neuronal damage caused by epileptic discharges in SE patients. Seizure-induced long-term injuries were also observed in the follow-up MRI.
authors.affiliation: Department of Neurology, Chiayi Branch, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan.
authors.forename: Yen-Chu
authors.initials: YC
authors.lastname: Huang
authors.forename: Hsu-Huei
authors.initials: HH
authors.lastname: Weng
authors.forename: Yu-tai
authors.initials: YT
authors.lastname: Tsai
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Huang
authors.forename: Ming-Chang
authors.initials: MC
authors.lastname: Hsiao
authors.forename: Chih-Ying
authors.initials: CY
authors.lastname: Wu
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Lin
authors.forename: Huan-Lin
authors.initials: HL
authors.lastname: Hsu
authors.forename: Jiann-Der
authors.initials: JD
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000175:diagnosis*; D013997:Time Factors; D055815:Young Adult