Transient postictal magnetic resonance imaging abnormality of the corpus callosum in a patient with epilepsy. Case report and review of the literature

J Neurosurg. 2002 Sep;97(3):714-7. doi: 10.3171/jns.2002.97.3.0714.

Abstract

Transient neuroimaging abnormalities associated with seizure activity have received little attention in the literature. The authors report a focal magnetic resonance (MR) imaging abnormality of the corpus callosum in a patient following a secondary generalized seizure. A 27-year-old right-handed man presented with a history of medically refractory partial seizures since the age of 1 year. The results of an MR imaging study obtained 4 months prior to the patient undergoing video-electroencephalography monitoring were unremarkable. After the patient discontinued all antiepileptic medications, a secondary generalized seizure of right temporal origin was recorded. Five days later, repeated MR imaging revealed a nonenhancing 14 x 11-mm ovoid hyperintense lesion in the splenium of corpus callosum. The patient was asymptomatic, and his neurological and neurocognitive examinations remained unremarkable. Follow-up MR imaging 5 weeks and 1 year later demonstrated near-complete resolution of the lesion. Benign and transient abnormalities in the splenium can occur as a periictal phenomenon. A high index of suspicion and follow-up imaging may prevent further unwarranted intervention.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Agenesis of Corpus Callosum*
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology
  • Epilepsies, Partial / diagnostic imaging
  • Epilepsies, Partial / pathology*
  • Hippocampus / diagnostic imaging
  • Hippocampus / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / pathology
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon