Focal cerebral magnetic resonance changes associated with partial status epilepticus

Epilepsia. Jan-Feb 1994;35(1):35-41. doi: 10.1111/j.1528-1157.1994.tb02909.x.

Abstract

We report 2 patients with transient abnormalities on magnetic resonance imaging (MRI) associated with partial status epilepticus (SE). A man with a 4-month history of partial seizures had complex partial SE for 9 days, with left temporal maximum on ictal EEG. Left temporal lobe T2 signal was increased on MRI during SE, but cerebral MRI was normal 9 weeks later. A woman with "cryptogenic" temporal lobe epilepsy for 16 years had complex partial SE for 1 week, with right temporal maximum on ictal EEG. T2 Signal was increased over the entire right temporal lobe, extending into the insula, without mass effect, on MRI 1 month after SE ended. Repeat MRI 1 month later showed marked decrease in volume of increased T2 intensity, without gadolinium enhancement, but with mild mass effect over the right anterioinferomesial temporal areas. A gemistocytic astrocytoma was resected. Focal cerebral MRI abnormalities consistent with cerebral edema may be due to partial SE but also may indicate underlying glioma, even in long-standing partial epilepsy. Focal structural imaging changes consistent with neoplasm should be followed to full resolution after partial SE.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Astrocytoma / diagnosis
  • Astrocytoma / pathology
  • Brain / pathology*
  • Brain Edema / diagnosis
  • Brain Edema / pathology
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology
  • Epilepsies, Partial / diagnosis*
  • Epilepsy, Complex Partial / diagnosis
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Status Epilepticus / diagnosis*
  • Temporal Lobe / pathology