Abstracts

MRI changes in partial status epilepticus (PSE)have been previously reported and include increased signal changes in the hippocampus or the neocortex on T2 weighted imaging.
Human and animal studies of PSE indicated that these changes are related to increased local cerebral blood flow and cytotoxic edema.
We studied acute MRI changes following partial status epilepticus and late follow-up MRI findings. Six consecutive patients with simple partial and complex partial status epilepticus documented by EEG were identified
Brain MRI using a 1.5 T Seimens or GE consisting of fluid attenuated inversion recovery (FLAIR); T1 weighted SPGR and T2 spin echo images were obtained within 24-48 hours of status epilepticus. A follow-up MRI was available in 4/6 patients. Two patients had increased signal changes on FLAIR MRI involving the grey matter in a gyriform pattern without involvement of the white matter (superior frontal gyrus and peri-central gyri). Four patients had increased signal within the hippocampus without involvement of adjacent peri-hippocampal structures. In 3/4 of the patients without hippocampal MRI signal changes, seizure onset was extra-temporal with secondary temporal propagation. On follow-up MRI 2/2 patients had resolution of neocortical signal changes without atrophy. In 2/2 patients with follow-up MRI had resolution of hippocampal increased signal. However, one patient developed hippocampal atrophy. MRI findings following partial status epilepticus consist of gyriform increased signal intensity or hippocampal increased signal intensity that resolves on follow-up MRI.
Furthermore, hippocampal increased signal occurs with partial status epilepticus of extra-temporal origin with secondary temporal propagation, and can lead to hippocampal atrophy in some cases.