title: A prospective study of diffusion weighted magnetic resonance imaging abnormalities in patients with cluster of seizures and status epilepticus.
abstract: OBJECTIVE
  To study the frequency, imaging characteristics, and clinical predictors for development of periictal diffusion weighted MRI abnormalities.
  
  
  METHODS
  We prospectively analyzed electro clinical and imaging characteristic of adult patients with cluster of seizures or status epilepticus between November 2013 and November 2015, in whom the diffusion weighted imaging was done within 24h after the end of last seizure (clinical or electrographic).
  
  
  RESULTS
  There were thirty patients who fulfilled the inclusion and exclusion criteria. Twenty patients (66%) had periictal MRI abnormalities. Nine patients (34%) did not have any MRI abnormality. All the patients with PMA had abnormalities on diffusion weighted imaging (DWI). Hippocampal abnormalities were seen in nine (53%), perisylvian in two (11.7%), thalamic in five (30%), splenium involvement in two (11.7%) and cortical involvement (temporo-occipital, parieto-occipital, temporo-parietal, fronto-parietal and fronto-temporal) in sixteen (94.1%) patients. Complete reversal of DWI changes was noted in sixteen (80%) patients and four (20%) patients showed partial resolution of MRI abnormalities. Mean duration of seizures was significantly higher among patients with PMA (59.11+20.97h) compared to those without MRI changes (27.33+9.33h) (p<0.001).
  
  
  CONCLUSIONS
  Diffusion abnormalities on MRI are common in patients with cluster of seizures and status epilepticus and were highly concordant with clinical semiology and EEG activity. Patients with longer duration of seizures/status were more likely to have PMA.
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: drjabeennims@gmail.com.
authors.forename: S A
authors.initials: SA
authors.lastname: Jabeen
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: drpavancherukuri@Gmail.Com.
authors.forename: Pavankumar
authors.initials: P
authors.lastname: Cherukuri
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: rukminimridula@gmail.com.
authors.forename: Rukmini
authors.initials: R
authors.lastname: Mridula
authors.affiliation: Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: kr.harsha@gmail.com.
authors.forename: K R
authors.initials: KR
authors.lastname: Harshavardhana
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: padmajagaddamanugu@Yahoo.Co.In.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Gaddamanugu
authors.affiliation: Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: sailajasarva@hotmail.com.
authors.forename: Sailaja
authors.initials: S
authors.lastname: Sarva
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: meenaak@hotmail.com.
authors.forename: A K
authors.initials: AK
authors.lastname: Meena
authors.affiliation: Department of Neurology, Millennium Block, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 50082, India. Electronic address: rupam_b@hotmail.com.
authors.forename: Rupam
authors.initials: R
authors.lastname: Borgohain
authors.affiliation: Department of Radiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. Electronic address: Email.yjyotsna@yahoo.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Jyotsna Rani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012640:Seizures / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D013226:Status Epilepticus / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
keywords: Apparent diffusion coefficient; Complex partial seizures; Diffusion weighted imaging; Generalized tonic clonic seizures; Non convulsive status epilepticus; Periictal magnetic resonance imaging; Periodic lateralized epileptiform discharges; Simple partial seizures