Turkish Neurosurgery 2013 , Vol 23 , Num 2
Reversible Focal Radiological Changes due to Non-Convulsive Status Epilepticus of the Right Parietooccipital Lobe
Nhat Nguyen TUAN HUYNH1, Akutsu HIROYOSHI1, Noguchi SHOZO2, Tsunoda TAKASHI2, Tsurushima HIDEO1, Matsumura AKIRA1
1University of Tsukuba, Graduate School of Comprehensive Human Science, Department of Neurosurgery, Tsukuba, Japan
2Ibaraki Central Hospital, Department of Neurosurgery, Kasama, Japan
3Cho Ray Hospital, Department of Radiology, Ho Chi Minh, Viet Nam
DOI : 10.5137/1019-5149.JTN.4870-11.0 We describe a 62-year-old woman suffering from visual hallucination due to focal status epilepticus investigated by means of Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA), Electroencephalography (EEG), and 99m Technetium ethylcysteinate dimer Single Photon Emission Computed Tomography (Tc-99m ECD SPECT). EEG showed spikes in the right parietooccipital area. MRI demonstrated gyral swelling and signal hyperintensity in the right parietooccipital cortex with effacement of adjacent cortical sulci on T2- weighted and Fluid Attenuation Inversion Recovery (FLAIR) images. MRA indicated localized dilation of the right posterior cerebral artery (PCA) and parietal branch of the right middle cerebral artery (MCA), corresponding to the epileptic area shown on EEG. Hyperperfusion in the right parietooccipital lobe was observed by Tc-99m ECD SPECT. All these findings completely resolved on the follow-up studies 2 months later. We present the case showing the transient radiological alterations on MRA corresponding to the epileptic area. Keywords : Status epilepticus, Reversible MRI, SPECT, MRA, Hyperperfusion
Corresponding author : Tsurushima Hıdeo, hideo-tsurushima@md.tsukuba.ac.jp