Transient Abnormalities on Magnetic Resonance Imaging after Absence Seizures.
10.26815/jkcns.2018.26.4.280
- Author:
Hye Won YOO
1
;
Lira YOON
;
Hye Young KIM
;
Min Jung KWAK
;
Kyung Hee PARK
;
Mi Hye BAE
;
Yunjin LEE
;
Sang Ook NAM
;
Young Mi KIM
Author Information
1. Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Busan, Korea. pink2129@naver.com
- Publication Type:Case Report
- Keywords:
Epilepsy;
Absence epilepsy;
Peri-ictal MRI abnormalities;
Differential diagnosis
- MeSH:
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
- From:
Journal of the Korean Child Neurology Society
2018;26(4):280-283
- CountryRepublic of Korea
- Language:English
-
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.
