Dynamic Changes of MRI Findings after Seizures / 대한간질학회지

ABSTRACT

INTRODUCTION: Magnetic resonance imaging has demonstrated reversible peri-ictal MRI changes suggestive of hemodynamic changes or cytotoxic edema. We were to investigate the dynamic peri-ictal MRI changes in patients with seizures. METHODS: We retrospectively reviewed the medical records, electroencephalography, and initial and follow-up MRI of 5 patients with single seizure or status epilepticus. We analyzed the patterns and locations of MRI abnormalities and their relationship with characteristics of seizures. RESULTS: Two patients with complex partial seizures (CPS) and versive or unilateral tonic seizures showed high signal changes in frontal cortex on T2-weighted (T2WI), fluid attenuated inversion recovery (FLAIR) and DWI. Three patients had MRI changes in mesial temporal structures including hippocampus after single generalized tonic-clinic seizure without encephalitic features clinically. One patient had multiple signal abnormalities in the left temporo-parietal, mesial temporal, insular cortices and thalamus on T2WI and FLAIR after frequent CPS. All of the lesions disappeared or resolved partially on the follow-up MRI. CONCLUSION: Our results showed that variable MRI changes in peri-ictal phase are possible at cortical as well as at subcortical areas. The dynamic MRI changes can be associated even in patients with single clinical seizure, suggesting that these changes are not related to the seizure frequency.