J Korean Child Neurol Soc.  2018 Dec;26(4):280-283. 10.26815/jkcns.2018.26.4.280.

Transient Abnormalities on Magnetic Resonance Imaging after Absence Seizures

Affiliations
  • 1Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Busan, Korea. pink2129@naver.com
  • 2Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Yangsan, Korea.

Abstract

Magnetic resonance imaging (MRI) is recommended for patients with epileptic seizures to rule out an underlying focal lesion. However, abnormalities in idiopathic generalized epilepsy, including childhood absence epilepsy, cannot usually be identified using brain imaging modalities such as MRI. Peri-ictal MRI abnormalities have been most commonly reported secondary to status epilepticus and are rarely observed in patients with focal seizures and generalized tonic-clonic seizures. Transient peri-ictal MRI abnormalities in absence epilepsy are extremely rare. A five-year-old girl presented with a three-day history of absence seizures that persisted despite continued treatment with sodium valproate. Electroencephalography showed bursts of generalized 3-Hz spike-and-wave discharges, during and after hyperventilation. Abnormal cortex thickening in the left perisylvian region was detected on T2-weighted brain MRI, and cortical dysplasia or a tumor was suspected. The patient started treatment with lamotrigine and was seizure-free after one month. The abnormal MRI lesion was completely resolved at the two-month follow-up. We report on a patient with childhood absence epilepsy and reversible brain MRI abnormalities in the perisylvian region. To our knowledge, this is the first report of transient MRI abnormalities after absence seizures. Transient peri-ictal MRI abnormalities should be considered for differential diagnosis in patients with absence seizures and a focal abnormality on brain MRI.

Keyword

Epilepsy; Absence epilepsy; Peri-ictal MRI abnormalities; Differential diagnosis

MeSH Terms

Brain
Diagnosis, Differential
Electroencephalography
Epilepsy
Epilepsy, Absence*
Epilepsy, Generalized
Female
Follow-Up Studies
Humans
Hyperventilation
Magnetic Resonance Imaging*
Malformations of Cortical Development
Neuroimaging
Seizures
Status Epilepticus
Valproic Acid
Valproic Acid
Full Text Links
  • JKCNS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr