MRI findings in aphasic status epilepticus
Article first published online: 3 JUN 2008
© 2008 International League Against Epilepsy
Volume 49, Issue 8, pages 1465–1469, August 2008
How to Cite
Toledo, M., Munuera, J., Sueiras, M., Rovira, R., Álvarez-Sabín, J. and Rovira, A. (2008), MRI findings in aphasic status epilepticus. Epilepsia, 49: 1465–1469. doi: 10.1111/j.1528-1167.2008.01620.x
- Issue published online: 28 JUL 2008
- Article first published online: 3 JUN 2008
- Accepted March 13, 2008; Online Early publication June 3, 2008.
- Status epilepticus;
- Aphasic status epilepticus;
Ictal-MRI studies including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), and MR-angiography (MRA) in patients with aphasic status epilepticus (ASE) are lacking. In this report, we aim to describe the consequences of the ASE on DWIs and its impact on cerebral circulation. We retrospectively studied eight patients with ASE confirmed by ictal-EEG, who underwent ictal-MRI shortly after well-documented onset (mean time delay 3 h). ASE consisted in fluctuating aphasia, mostly associated with other subtle contralateral neurological signs such as hemiparesia, hemianopia, or slight clonic jerks. In MRI, six patients showed cortical temporoparietal hyperintensity in DWI and four of them had also ipsilateral pulvinar lesions. Five patients showed close spatial hyperperfusion areas matching the DWI lesions and an enhanced blow flow in the middle cerebral artery. Parenchymal lesions and hemodynamic abnormalities were not associated with seizure duration or severity in any case. The resolution of DWI lesions at follow-up MRI depended on the length of the MRIs interval. In patients with ASE, lesions on DWI in the temporo-parietal cortex and pulvinar nucleus combined with local hyperperfusion can be observed, even when they appear distant from the epileptic focus or the language areas.