Hyperacute Seizure 08 - Clinical Case Summary
Hyperacute Seizure 08 - Clinical Case Summary
Hyperacute Seizure 08 - Clinical Case Summary
SummaryHistory
36 yo male with episode of speech arrest, inattention, and repetitive arm motions.
Exams Performed
MR Coronal T2-w spin echo and MR FLAIR; MR diffusion
Prior available imaging reports
CT Head and T1-w imaging is not available
MR Coronal T2-w spin echo and MR FLAIR
1. Positive evidence of acute seizure activity involving a very limited segment of the mesial left temporal cortex and adjacent mid-body, hippocampus, as above.
2. There is no evidence of status epilepticus.
MR Diffusion (DWI)
1. Focal brain edema is evident as T2-w shine-through in the mesial left temporal lobe, as above. There is no acute water restriction.
MR Susceptibility (SWI) is not available
MR Coronal T2-w spin echo and MR FLAIR
1. Positive evidence of acute seizure activity involving a very limited segment of the mesial left temporal cortex and adjacent mid-body, hippocampus, as above.
2. There is no evidence of status epilepticus.
MR Diffusion (DWI)
1. Focal brain edema is evident as T2-w shine-through in the mesial left temporal lobe, as above. There is no acute water restriction.
MR Susceptibility (SWI) is not available
Overall impression
1. There is evidence of an acute seizure event affecting, in this case, the left hippocampus plus the entorhinal and pararhinal mesial temporal cortex. The hippocampal changes affect mainly the CA1-subiculum cortex, which can be overlooked without careful analysis. Therefore, it is helpful to look and surrounding cortex, especially the entorhinal and pararhinal cortex to see if it is edematous as well. If so, the subtle hippocampal changes can reliably be described as evidence of abnormal, post seizure findings.
Lessons to be Learned
Post seizure edema is occasionally evident in the entorhinal cortex, as well as, the hippocampus. This is not considered evidence of status epilepticus.
