Postictal subcortical restricted diffusion in a child with focal symptomatic epilepsy.
BACKGROUND
Diffusion abnormalities on MRI are well described after prolonged seizures. However, isolated, focal, subcortical restricted diffusion is uncommon.


METHODS
A girl of Kurdish descent experienced focal-onset epilepsy secondary to a left thalamic infarction at age 3 years. At age 6 years, she developed status epilepticus in the context of a febrile illness.


RESULTS
Four days after the seizure, she had neurological deterioration including involuntary posturing movements and irritability. A brain MRI revealed left hemisphere subcortical restricted diffusion, predominantly in the frontal and occipital regions. She experienced persistent right hemiparesis for 2 months after the initial seizure.


CONCLUSIONS
This presentation is reminiscent of acute encephalopathy with biphasic seizures and late reduced diffusion, a syndrome thus far reported almost exclusively in Japan. This represents one of the few documented examples of acute encephalopathy with biphasic seizures and late reduced diffusion in an individual not of east Asian descent.
Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada. Electronic address: kmyers@ucalgary.ca.
Kenneth A
KA
Myers
Division of Radiology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Mehmet S
MS
Albayram
Section of Neurology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Aleksandra
A
Mineyko
D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D004828:Epilepsies, Partial / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010291:Paresis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology
acute encephalopathy with biphasic seizures and late reduced diffusion; epilepsy; hemiparesis; magnetic resonance imaging; status epilepticus