J Korean Epilepsy Soc.  2006 Dec;10(2):111-117.

Dynamic Changes of MRI Findings after Seizures

• Kang HJ
• Kim JH
• Lee JH
• Kim HJ
• Song HS
• Choi KK
• Park KD
• Lim SM
• Lee HW

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.

Keyword

Peri-ictal; MRI; Dynamic; Seizures

MeSH Terms

Edema
Electroencephalography
Epilepsy
Follow-Up Studies
Hemodynamics
Hippocampus
Humans
Magnetic Resonance Imaging*
Medical Records
Retrospective Studies
Seizures*
Status Epilepticus
Thalamus