Transient Imaging Findings Related to Status Epilepticus

Abstract

Objectives:We aim to draw attention to transient imaging findings related to epileptic seizures, which is a rare condition that is often overlooked 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 seizure 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.

Keywords

• cranial magnetic resonance imaging
• prognosis
• status epilepticus
• transient imaging findings