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Differential Changes on Diffusion-Weighted MRI in a Patient with Partial Status Epilepticus: Case Report

Received: 17 October 2016    Accepted: 27 December 2016    Published: 27 March 2017
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Abstract

We report a patient who showed mixed cytotoxic and vasogenic edema on Magnetic Resonance Imaging (MRI) in association with partial status epilepticus. The patient experienced clonic movements of the left arm and leg. As the clonic movements continued, resulting eventually in epilepsia partialis continua, MRI showed characteristic cytotoxic edema in the epileptogenic focus and vasogenic edema in the region remote from the epileptogenic focus. The aim of this report is to support the evidence that partial seizure spreads through efferent projections from the cerebral cortex to the cerebellum, and findings of serially followed MRI suggest that cytotoxic edema persisted for a long time in contrast to vasogenic edema.

Published in Clinical Neurology and Neuroscience (Volume 1, Issue 1)
DOI 10.11648/j.cnn.20170101.15
Page(s) 20-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Partial Status Epilepticus, MRI, Cytotoxic Brain Edema, Vasogenic Brain Edema

References
[1] Wieshmann UC, Symms MR, Shorvon SD. Diffusion changes in status epilepticus. Lancet 1997; 350: 493-494.
[2] Donaire A, Carreno M, Gomez B, et al. Cortical laminar necrosis related to prolonged focal status epilepticus. J Neurol Neurosurg Psychiatry 2006; 77: 104-106.
[3] Lansberg MG, O'Brien MW, Norbash AM, Moseley ME, Morrell M, Albers GW. MRI abnormalities associated with partial status epilepticus. Neurology 1999; 52: 1021-1027.
[4] Gass A, Niendorf T, Hirsch JG. Acute and chronic changes of the apparent diffusion coefficient in neurological disorders--biophysical mechanisms and possible underlying histopathology. J Neurol Sci 2001; 186 Suppl 1: S15-23.
[5] Senn P, Lovblad KO, Zutter D, et al. Changes on diffusion-weighted MRI with focal motor status epilepticus: case report. Neuroradiology 2003; 45: 246-249.
[6] Hong KS, Cho YJ, Lee SK, Jeong SW, Kim WK, Oh EJ. Diffusion changes suggesting predominant vasogenic oedema during partial status epilepticus. Seizure 2004; 13: 317-321.
[7] Oztas B, Kilic S, Dural E, Ispir T. Influence of antioxidants on the blood-brain barrier permeability during epileptic seizures. J Neurosci Res 2001; 66: 674-678.
[8] Calistri V, Caramia F, Bianco F, Fattapposta F, Pauri F, Bozzao L. Visualization of evolving status epilepticus with diffusion and perfusion MR imaging. AJNR Am J Neuroradiol 2003; 24: 671-673.
[9] Kimiwada T, Juhasz C, Makki M, et al. Hippocampal and thalamic diffusion abnormalities in children with temporal lobe epilepsy. Epilepsia 2006; 47: 167-175.
[10] Szabo K, Poepel A, Pohlmann-Eden B, et al. Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain 2005; 128: 1369-1376.
[11] Hattori H, Matsuoka O, Ishida H, Hisatsune S, Yamano T. Magnetic resonance imaging in occipital lobe epilepsy with frequent seizures. Pediatr Neurol 2003; 28: 216-218.
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    Jang Sang Hyun. (2017). Differential Changes on Diffusion-Weighted MRI in a Patient with Partial Status Epilepticus: Case Report. Clinical Neurology and Neuroscience, 1(1), 20-23. https://doi.org/10.11648/j.cnn.20170101.15

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    ACS Style

    Jang Sang Hyun. Differential Changes on Diffusion-Weighted MRI in a Patient with Partial Status Epilepticus: Case Report. Clin. Neurol. Neurosci. 2017, 1(1), 20-23. doi: 10.11648/j.cnn.20170101.15

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    AMA Style

    Jang Sang Hyun. Differential Changes on Diffusion-Weighted MRI in a Patient with Partial Status Epilepticus: Case Report. Clin Neurol Neurosci. 2017;1(1):20-23. doi: 10.11648/j.cnn.20170101.15

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  • @article{10.11648/j.cnn.20170101.15,
      author = {Jang Sang Hyun},
      title = {Differential Changes on Diffusion-Weighted MRI in a Patient with Partial Status Epilepticus: Case Report},
      journal = {Clinical Neurology and Neuroscience},
      volume = {1},
      number = {1},
      pages = {20-23},
      doi = {10.11648/j.cnn.20170101.15},
      url = {https://doi.org/10.11648/j.cnn.20170101.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20170101.15},
      abstract = {We report a patient who showed mixed cytotoxic and vasogenic edema on Magnetic Resonance Imaging (MRI) in association with partial status epilepticus. The patient experienced clonic movements of the left arm and leg. As the clonic movements continued, resulting eventually in epilepsia partialis continua, MRI showed characteristic cytotoxic edema in the epileptogenic focus and vasogenic edema in the region remote from the epileptogenic focus. The aim of this report is to support the evidence that partial seizure spreads through efferent projections from the cerebral cortex to the cerebellum, and findings of serially followed MRI suggest that cytotoxic edema persisted for a long time in contrast to vasogenic edema.},
     year = {2017}
    }
    

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    AB  - We report a patient who showed mixed cytotoxic and vasogenic edema on Magnetic Resonance Imaging (MRI) in association with partial status epilepticus. The patient experienced clonic movements of the left arm and leg. As the clonic movements continued, resulting eventually in epilepsia partialis continua, MRI showed characteristic cytotoxic edema in the epileptogenic focus and vasogenic edema in the region remote from the epileptogenic focus. The aim of this report is to support the evidence that partial seizure spreads through efferent projections from the cerebral cortex to the cerebellum, and findings of serially followed MRI suggest that cytotoxic edema persisted for a long time in contrast to vasogenic edema.
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Author Information
  • Department of Neurology, Eulji University School of Medicine, Daejeon, Korea

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