Extensive Hemispheric Involvement on Diffusion-Weighted Image in a Patient with Status Epilepticus

ABSTRACT

Epileptic seizures have been shown to cause increased signal intensities on diffusion-weighted images (DWI). Extensive hemispheric involvement on MRI after status epilepticus was very rare. A 56-year-old man transferred to our hospital due to status epileticus. The status epilepticus lasted nearly 7 hours. Neurological examination showed confusional consciousness, left hemiplegia and hemineglect of left side. Brain DWI demonstrated extensive high signal intensities in the right posterior frontal, parietal, temporal and occipital lobes resembling acute cerebral infarction. EEG revealed periodic lateralized epileptiform discharges over the right hemisphere. Follow-up DWI showed more decreased signal intensity in right hemispheric lesions. This case demonstrates the importance of recognizing the characteristics that help differentiate status epilepticus from other disorders.