Neuronal damage confirmed by 1H-MRS in occipital lobe complex partial status epilepticus.
- Author:
Bum Chun SUH
1
;
Ok Jun KIM
;
Hyon Sook KIM
;
Chul Hee CHOI
;
Seo Hyun KIM
;
Byung In LEE
Author Information
1. Department of Neurology, Yonsei University, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Occipital complex partial status epilepticus;
Neuronal damage
- MeSH:
Aged;
Brain;
Electroencephalography;
Female;
Follow-Up Studies;
Hallucinations;
Humans;
Magnetic Resonance Imaging;
Memory;
Neurons*;
Occipital Lobe*;
Phenytoin;
Seizures;
Status Epilepticus*
- From:Journal of the Korean Neurological Association
1999;17(1):177-182
- CountryRepublic of Korea
- Language:Korean
-
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.
