Abstracts

Rationale: Status epilepticus (SE) is a common neurological emergency for which there is limited information on resultant neuroimaging changes. The objective of this study was to characterize the abnormalities associated with SE in cranial magnetic resonance imaging (MRI) of patients with SE. Methods: A retrospective review of our EEG database was conducted. The patients included in the EEG database were admitted between the years 2001 and 2010. In total 203 patients were identified with SE. Inclusion criteria were: (1) seizures lasting a minimum of 30 minutes or recurrent seizures without recovery in between them for at least 30 minutes including nonconvulsive electrographic seizures (2) cerebral MRI showing signal change after SE in sequences temporally related to seizures (3) MRI changes not attributed to an underlying primary neurological disorder including the condition that precipitated the SE. Ethics approval was obtained according to our institutional standards. Results: Ten patients (4 female; mean age 35.4 + 11.96 SD years) were suitable. MRI findings included increased T2 signal changes in the grey and/or white matter with corresponding diffusion-weighted abnormalities (n=9). Apparent diffusion coefficient (ADC) values were reduced in four patients and increased in three. Findings also included changes affecting one cerebral hemisphere (n=1), perilesional and homologous region (n=1), hippocampi (n=9), thalamus and basal ganglia (n=3), and brainstem and cerebellum (n=3). Some signal changes were reversible and others irreversible. Conclusions: Young patients with SE showed changes on MRI that were attributable to SE and were focal, multifocal, hemispheric, and diffuse. Notably MRI changes were found beyond the hippocampi and limbic structures, involving the brainstem, cerebellum, basal ganglia and thalamus. MRI changes in the latter areas have not been previously well described and require greater attention.