(Bezmialem Vakıf Üniversitesi,Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)
Nerses BEBEK
(İstanbul Üniversitesi, Tıp Nöroloji Bölümü, Mühendislik Fakültesi, İstanbul, Türkiye)
Yıl: 2021Cilt: 27Sayı: 1ISSN: 1300-7157Sayfa Aralığı: 15 - 22Türkçe

79 0
Transient Imaging Findings Related to Status Epilepticus
Objectives: We aim to draw attention to transient imaging findings related to epileptic seizures, which is a rare condition that is often over-looked and may even lead to misdiagnosis.Methods:Records of 106 patients with seizures were reviewed and patients with transient magnetic resonance imaging (MRI) findings were detected. Seizure type and transient imaging findings (TIF) features were analyzed retrospectively.Results:Status epilepticus (SE) was found in 45 of the 106 patients who had epileptic seizures, and 9 of them had TIF. The average age of the patients was 52.9 years (28–78). The first seizure was a SE in eight (89%) patients. Three (33.3%) had a focal SE, four (44.4%) had a generalized tonic-clonic SE, whereas two (22.2%) evolved from a focal seizure to a bilateral tonic-clonic seizure. All patients with focal features had a sei-zure semiology that was compatible with the TIF side. In cranial MRI, cortical changes were detected in six, thalamic changes in one, cortical and thalamic changes in one, and leptomeningeal enhancements in one patient. These changes returned to normal in all patients within two weeks. Two patients died due to non-SE causes, whereas other patients resumed their daily routines.Conclusion:MRI findings after SE are rare but if detected, are an important indicator with localization and lateralization values, contributing to the semiological findings and localization. It is often confused with conditions that are its differential diagnosis. Knowing the MRI changes associated with SE is important to avoid misdiagnosis, understand its pathophysiology, and determine the prognosis.
DergiAraştırma MakalesiErişime Açık
  • 1. Hopkins A, Shorvon S, Cascino G. Epilepsy. London: Chapman and Hall; 1995. p. 331–50.
  • 2. Akpınar ÇK, Cengiz N. Current Diagnosis, Treatment and Etiology of Status Epilepticus. Epilepsi 2014;20(1):1–10.
  • 3. Leitinger M, Trinka E, Giovannini G, Zimmermann G, Florea C, Rohracher A, et al. Epidemiology of status epilepticus in adults: A population-based study on incidence, causes, and outcomes. Epilepsia 2019;60(1):53–62.
  • 4. Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al; Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012;17(1):3–23.
  • 5. Horsley V. An Address on the Origin and Seat of Epileptic Disturbance: Delivered before the Cardiff Medical Society. Br Med J 1892;1(1631):693–6.
  • 6. Rumack CM, Guggenheim MA, Fasules JW, Burdick D. Transient positive postictal computed tomographic scan. J Pediatr 1980;97(2):263–4.
  • 7. Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, Shorvon S, Lowenstein DH. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015;56(10):1515–23.
  • 8. Fisher RS, Cross JH, D’Souza C, French JA, Haut SR, Higurashi N, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia 2017;58(4):531–42.
  • 9. Riviello JJ Jr, Ashwal S, Hirtz D, Glauser T, Ballaban-Gil K, Kelley K, et al. Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2006;67(9):1542–50.
  • 10. Lyons TW, Johnson KB, Michelson KA, Nigrovic LE, Loddenkemper T, Prabhu SP, et al. Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus. Seizure 2016;35:4–10.
  • 11. Milligan TA, Zamani A, Bromfield E. Frequency and patterns of MRI abnormalities due to status epilepticus. Seizure 2009;18(2):104-8.
  • 12. Kim JA, Chung JI, Yoon PH, Kim DI, Chung TS, Kim EJ, et al. Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. AJNR Am J Neuroradiol 2001;22(6):1149–60.
  • 13. Lansberg MG, O’Brien MW, Norbash AM, Moseley ME, Morrell M, Albers GW. MRI abnormalities associated with partial status epilepticus. Neurology 1999;52(5):1021–7.
  • 14. Diehl B, Najm I, Ruggieri P, Tkach J, Mohamed A, Morris H, et al. Postictal diffusion-weighted imaging for the localization of focal epileptic areas in temporal lobe epilepsy. Epilepsia 2001;42(1):21–8.
  • 15. Vollmar C, Noachtar S. Neuroimaging in Epilepsy. Türk Nöroloji Dergisi 2004;10(3):185–200.
  • 16. Meletti S, Monti G, Mirandola L, Vaudano AE, Giovannini G. Neuroimaging of status epilepticus. Epilepsia 2018;59(Suppl 2):113–9.
  • 17. Samaniego EA, Stuckert E, Fischbein N, Wijman CA. Crossed cerebellar diaschisis in status epilepticus. Neurocrit Care 2010;12(1):88–90.
  • 18. Friedman E. Epilepsy imaging in adults: getting it right. AJR Am J Roentgenol 2014;203(5):1093–103.
  • 19. 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(5):317–21.
  • 20. Meletti S, Giovannini G, d’Orsi G, Toran L, Monti G, Guha R, et al. New-Onset Refractory Status Epilepticus with Claustrum Damage: Definition of the Clinical and Neuroimaging Features. Front Neurol 2017;8:111.
  • 21. Choy M, Cheung KK, Thomas DL, Gadian DG, Lythgoe MF, Scott RC. Quantitative MRI predicts status epilepticus-induced hippocampal injury in the lithium-pilocarpine rat model. Epilepsy Res 2010;88(2-3):221–30.
  • 22. Guerriero RM, Gaillard WD. Imaging modalities to diagnose and localize status epilepticus. Seizure 2019;68:46–51.22
  • 23. Nakae Y, Kudo Y, Yamamoto R, Dobashi Y, Kawabata Y, Ikeda S, et al. Relationship between cortex and pulvinar abnormalities on diffusion-weighted imaging in status epilepticus. J Neurol 2016;263(1):127–32.
  • 24. Ohe Y, Hayashi T, Deguchi I, Fukuoka T, Horiuchi Y, Maruyama H, et al. MRI abnormality of the pulvinar in patients with status epilepticus. J Neuroradiol 2014;41(4):220–6.
  • 25. Mendes A, Sampaio L. Brain magnetic resonance in status epilepticus: A focused review. Seizure 2016;38:63–7.
  • 26. Aellen J, Abela E, Buerki SE, Kottke R, Springer E, Schindler K, et al. Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI). Eur Radiol 2014;24(11):2980–8.
  • 27. Lazeyras F, Blanke O, Zimine I, Delavelle J, Perrig SH, Seeck M. MRI, (1)H-MRS, and functional MRI during and after prolonged nonconvulsive seizure activity. Neurology 2000;55(11):1677–82.
  • 28. Kutluay E, Beattie J, Passaro EA, Edwards JC, Minecan D, Milling C, et al. Diagnostic and localizing value of ictal SPECT in patients with nonconvulsive status epilepticus. Epilepsy Behav 2005;6(2):212–7.
  • 29. Doherty CP, Cole AJ, Grant PE, Fischman A, Dooling E, Hoch DB, et al. Multimodal longitudinal imaging of focal status epilepticus. Can J Neurol Sci 2004;31(2):276–81.
  • 30. Tenney JR, Marshall PC, King JA, Ferris CF. fMRI of generalized absence status epilepticus in conscious marmoset monkeys reveals corticothalamic activation. Epilepsia 2004;45(10):1240–7

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.