J Korean Neurol Assoc.  1999 Jan;17(1):177-182.

Neuronal damage confirmed by 1H-MRS in occipital lobe complex partial status epilepticus

• Suh BC
• Kim OJ
• Kim HS
• Choi CH
• Kim SH
• Lee BI

Abstract

A 74-year old woman presented with partial and secondarily generalized status epilepticus lasted for 11 days. Initially her seizures consisted of only unformed visual hallucination, which progressed to formed hallucinations, and then memory disturbance and GTCs. During the period of recurrent formed visual hallucinations, T2-weighted brain MRI revealed high signal intensities in the left occipital lobe. After intravenous phenytoin loading, she did not develop any further GTCs but visual hallucinations persisted. Follow-up MRI performed after complete recovery of seizures showed complete recovery of the previous focal lesions, however, 1H-MRS showed a significant decrease of NAA in the recovered area. These features suggested the neuronal loss in the area of seizure focus, despite the complete recovery of transient focal abnormalities in MRI. This case provides a supportive evidence of neuronal damage even in focal status epilepticus, which stress the importance of early treatment and EEG confirmation of the complete seizure control after the disappearance of clinically obvious seizures.

Keyword

Occipital complex partial status epilepticus; Neuronal damage

MeSH Terms

Aged
Brain
Electroencephalography
Female
Follow-Up Studies
Hallucinations
Humans
Magnetic Resonance Imaging
Memory
Neurons*
Occipital Lobe*
Phenytoin
Seizures
Status Epilepticus*
Phenytoin