title: Serial EEG and MRI changes in status epilepticus-induced excitotoxic neuronal necrosis.
abstract: Prolonged status epilepticus may directly cause selective neuronal necrosis due to excitotoxic mechanisms, as observed in experimental models and described in case reports. A 36-year-old woman presented with right hemiplegia and aphasia following a generalised tonic-clonic status epilepticus of two hours duration. Accompanying serial MRI with advanced imaging techniques, EEG and histopathology of the cortical tissue of the patient were all compatible with excitotoxic neuronal necrosis. In this histopathologically-proven rare case of status epilepticus-induced excitotoxic neuronal injury, the observation of delayed cortical laminar necrosis on MRI, together with paroxysmal lateralised epileptiform discharges on the EEG, suggests that these changes may be an early sign of impending and ongoing excitotoxic neuronal injury and delayed cell death caused by glutamate release due to excessive neuronal firing in status epilepticus.
authors.affiliation: Department of Neurology, Acibadem University School of Medicine, Istanbul, Turkey.
authors.forename: Fehim
authors.initials: F
authors.lastname: Arman
authors.forename: Dilaver
authors.initials: D
authors.lastname: Kaya
authors.forename: Alp
authors.initials: A
authors.lastname: Dincer
authors.forename: Aydin
authors.initials: A
authors.lastname: Sav
authors.forename: M Necmettin
authors.initials: MN
authors.lastname: Pamir
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D004594:Electrophysiology; D004830:Epilepsy, Tonic-Clonic / Q000150:complications / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009336:Necrosis; D009460:Neurologic Examination; D009474:Neurons / Q000473:pathology*; D013226:Status Epilepticus / Q000150:complications / Q000473:pathology* / Q000503:physiopathology