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mri status epilepticus

Guy Bar-Klein, Rebecca Klee, Claudia Brandt, Marion Bankstahl, Pablo Bascuñana, Kathrin Töllner, Hotjensa Dalipaj, Jens P Bankstahl, Alon Friedman, Wolfgang Löscher
OBJECTIVE: Acquired epilepsy is a devastating long-term risk of various brain insults, including trauma, stroke, infections, and status epilepticus (SE). There is no preventive treatment for patients at risk. Due to the complex alterations involved in epileptogenesis, it is likely that multi-targeted approaches are required for epilepsy prevention. We report novel preclinical findings with isoflurane, which exerts various non-anesthetic effects that may be relevant for anti-epileptogenesis...
October 19, 2016: Annals of Neurology
Yusuke Toda, Mineo Yamazaki, Tomohiro Ota, Yosuke Fujisawa, Kazumi Kimura
A 64-year-old man with fever, appetite loss, and pain in the back of the neck visited our hospital. We diagnosed him as having bacterial meningitis because of pleocytosis of the cerebrospinal fluid, and started treatment with antibiotics. Multiple cerebral infarcts were found on brain MRI. We suspected that the origin of the bacterial meningitis was infective endocarditis, and administered Cefepime and Gentamicin according to the guidelines for treatment of infective endocarditis. Three days later, he became drowsy and had myoclonus and flapping of the extremities...
September 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
Takuya Matsuda, Shuichi Shimakawa, Hiromitsu Toshikawa, Mari Hatanaka, Miho Fukui, Atsushi Mori, Hiroshi Tamai
We report a 13-month-old girl who developed acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) with transient reduced diffusion in the hippocampus and anterior commissure on diffusion-weighted imaging (DWI), which was performed on the first day after febrile status epilepticus (FSE) as the initial neurological symptom of AESD. DWI just after late seizures showed high signal intensity lesions in both left hippocampus and anterior commissure, and left extratemporal and occipital subcortical white matter...
November 2016: Brain & Development
Simone Marziali, Francesca Di Giuliano, Eliseo Picchi, Silvia Natoli, Carlo Leonardis, Francesca Leonardis, Francesco Garaci, Roberto Floris
The presentation of carbon monoxide poisoning is non-specific and highly variable. Hyperbaric oxygen therapy is used for the treatment of this condition. Various reports show the occurrence of self-limiting seizures after carbon monoxide poisoning and as a consequence of hyperbaric oxygen therapy. Contrary to the seizures, status epilepticus has been rarely observed in these conditions. The exact pathophysiology underlying seizures and status epilepticus associated with carbon monoxide poisoning and hyperbaric oxygen therapy is not really clear, and some elements appear to be common to both conditions...
August 22, 2016: Neuroradiology Journal
Sara Hocker, Elanagan Nagarajan, Alejandro A Rabinstein, Dennis Hanson, Jeffrey W Britton
Importance: Prolonged seizures in super-refractory status epilepticus (SRSE) have been shown to cause neuronal death and reorganization, and visual inspection in individual case studies has demonstrated progressive cortical and subcortical atrophy. At present, magnetic resonance imaging (MRI) studies that evaluate brain atrophy in SRSE are lacking. Objectives: To document and quantify the development of atrophy over time in SRSE. Design, Setting, and Participants: This retrospective medical record review included all patients with SRSE who were admitted to a tertiary referral campus of the Mayo Clinic Hospital with SRSE from January 1, 2001, to December 31, 2013...
October 1, 2016: JAMA Neurology
Yoshinori Kobayashi, Yoshiyuki Hanaoka, Tomoyuki Akiayma, Iori Ohmori, Mamoru Ouchida, Toshiyuki Yamamoto, Makio Oka, Harumi Yoshinaga, Katsuhiro Kobayashi
We report a female patient with Dravet syndrome (DS) with erratic segmental myoclonus, the origin of which was first identified in the cerebral cortex by the detection of myoclonus-associated cortical discharges. The discharges were disclosed through jerk-locked back-averaging of electroencephalogram (EEG) data using the muscle activity of myoclonus as triggers. The detected spikes on the contralateral parieto-central region preceded myoclonic muscle activity in the forearms by 28-46ms. The patient was six months old at the time of examination, and was developing normally before seizure onset at two months of age...
August 11, 2016: Brain & Development
Svetlana Gataullina, Julia Lauer-Zillhardt, Anna Kaminska, Louise Galmiche-Rolland, Nadia Bahi-Buisson, Clément Pontoizeau, Chris Ottolenghi, Olivier Dulac, Catherine Fallet-Bianco
We report the cases of a brother and a sister of nonconsanguineous parents who developed progressive microcephaly and had tremor, irritability, spasticity, startle reflexes, and permanent erratic myoclonus since birth. Focal clonic seizures, status epilepticus, and infantile spasms appeared later, during the first months of life, while erratic myoclonic jerks persisted. Electroencephalogram initially showed multifocal spikes that evolved into modified hypsarrhythmia and then discontinuous activity, evoking the progressive nature of the condition...
August 14, 2016: Neuropediatrics
J Kalita, V E Mani, S K Bhoi, U K Misra
PURPOSE: To evaluate the spectrum of acute infectious encephalitis/encephalopathy syndrome (AIES) in intensive care unit (ICU) and the predictors of mechanical ventilation (MV) and outcome of these patients. METHODS: AIES patients diagnosed on the basis of fever, altered sensorium, seizure and cerebrospinal fluid (CSF) pleocytosis admitted to the neurology ICU were prospectively included. The demographic and clinical details, hematological, biochemical, MRI and etiological findings of the patients were noted...
August 10, 2016: QJM: Monthly Journal of the Association of Physicians
Rajeev Kumar Verma, Eugenio Abela, Kaspar Schindler, Heinz Krestel, Elisabeth Springer, Adrian Huber, Christian Weisstanner, Martinus Hauf, Jan Gralla, Roland Wiest
OBJECTIVE: The aim of this study was to investigate variant patterns of cortical venous oxygenation during status epilepticus (SE) using susceptibility-weighted imaging (SWI). METHODS: We analyzed magnetic resonance imaging (MRI) scans of 26 patients with clinically witnessed prolonged seizures and/or EEG-confirmed SE. All MRI exams encompassed SWI, dynamic susceptibility contrast perfusion MRI (MRI-DSC) and diffusion-weighted imaging (DWI). We aimed to identify distinct patterns of SWI signal alterations that revealed regional or global increases of cerebral blood flow (CBF) and DWI restrictions...
2016: PloS One
Markus Hutterer, Yvonne Ebner, Markus J Riemenschneider, Antje Willuweit, Mark McCoy, Barbara Egger, Michael Schröder, Christina Wendl, Dirk Hellwig, Jirka Grosse, Karin Menhart, Martin Proescholdt, Brita Fritsch, Horst Urbach, Günther Stockhammer, Ulrich Roelcke, Norbert Galldiks, Philipp Meyer, Karl-Josef Langen, Peter Hau, Eugen Trinka
: O-(2-[(18)F]-fluoroethyl)-L-tyrosine positron emission tomography ((18)F-FET PET) is a well-established method increasingly used for diagnosis, treatment planning and monitoring in gliomas. Epileptic activity, frequently occurring in glioma patients, can influence MRI findings. Whether seizures also affect (18)F-FET PET imaging is currently unknown. The aim of this retrospective analysis was to investigate the brain amino acid metabolism during epileptic seizures by (18)F-FET PET and to elucidate the pathophysiological background...
July 28, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Camilo Espinosa-Jovel, Rafael Toledano, Irene García-Morales, Juan Álvarez-Linera, Antonio Gil-Nagel
No abstract text is available yet for this article.
July 26, 2016: Neurology
Keita Kuya, Shinya Fujii, Fuminori Miyoshi, Koyo Ohno, Yuki Shinohara, Yoshihiro Maegaki, Toshihide Ogawa
A 1-year-old boy was admitted because of febrile status epilepticus (FSE). A secondary cluster of seizures was seen on day 5 after onset, and the patient eventually displayed developmental delay. Conventional magnetic resonance imaging (MRI) showed no abnormal findings on day 1 after onset, but showed reduced diffusion in the subcortical regions of bilateral frontal lobes on day 5 after onset. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was diagnosed. Arterial spin labeling (ASL) revealed reduced cerebral blood flow (CBF) in bilateral frontal lobes on day 1 after onset and showed increased CBF in the corresponding region in the subacute phase...
July 23, 2016: Brain & Development
Heike Breuer, Martin Meier, Sophie Schneefeld, Wolfgang Härtig, Alexander Wittneben, Martin Märkel, Tobias L Ross, Frank M Bengel, Marion Bankstahl, Jens P Bankstahl
Insult-associated blood-brain barrier leakage is strongly suggested to be a key step during epileptogenesis. In this study, we used three non-invasive translational imaging modalities, i.e. positron emission tomography, single photon emission computed tomography, and magnetic resonance imaging, to evaluate BBB leakage after an epileptogenic brain insult. Sprague-Dawley rats were scanned during early epileptogenesis initiated by status epilepticus. Positron emission tomography and single photon emission computed tomography scans were performed using the novel tracer [(68)Ga]DTPA or [(99m)Tc]DTPA, respectively...
July 19, 2016: Journal of Cerebral Blood Flow and Metabolism
Fenella Jane Kirkham
Pediatric neurology relies on ultrasound, computed tomography (CT), and magnetic resonance (MR) imaging. CT prevails in acute neurologic presentations, including traumatic brain injury (TBI), nontraumatic coma, stroke, and status epilepticus, because of easy availability, with images of diagnostic quality, e.g., to exclude hemorrhage, usually completed quickly enough to avoid sedation. Concerns over the risks of ionizing radiation mean re-imaging and higher-dose procedures, e.g., arteriography and venography, require justification...
2016: Handbook of Clinical Neurology
Irene Navalpotro-Gómez, Rosa María Vivanco-Hidalgo, Elisa Cuadrado-Godia, Santiago Medrano-Martorell, Francisco Alameda-Quitllet, Gloria Villalba-Martínez, Jaume Roquer
BACKGROUND: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is an uncommon disease of unknown etiology characterized by thickening of the cerebral dura mater with possible associated inflammation. The most frequently described clinical symptoms include headache, cranial nerve palsy, and cerebellar dysfunction. Epilepsy and/or status epilepticus as main presentation is very uncommon. CASE PRESENTATION: Two consecutive cases are presented of patients manifesting focal status epilepticus secondary to IHCP, with clinical, laboratory [blood test and cerebrospinal fluid (CSF) analysis], neuroradiologic [magnetic resonance imaging (MRI) at 3 Tesla and digital subtraction angiography (DSA)], and therapeutic data...
August 15, 2016: Journal of the Neurological Sciences
Seyed Hasan Tonekaboni, Narjes Jafari, Zahra Chavoshzadeh, Bibi Shahin Shamsian, Nima Rezaei
DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a potentially life-threatening syndrome, which reflects a serious hypersensitivity reaction to drugs, presenting by generalized skin rash, fever, eosinophilia, atypical lymphocytosis, and internal organ involvement. Herein a 21-month old male infant with DRESS and Encephalopathy syndrome is presented who complicated after phenobarbital usage that persisted due to phenytoin cream usage. The case received phenobarbital after a seizure disorder presented as "status epilepticus"...
September 2015: Turkish Journal of Pediatrics
Benjamin Tolchin, Tadeau Fantaneanu, Michael Miller, Jeffrey Helgager, Jong Woo Lee
This report discusses a case of nonconvulsive status epilepticus, caused by cerebral amyloid angiopathy-related inflammation. Brain biopsy demonstrated cerebral amyloid angiopathy, with clinical and radiographic features indicative of a fluctuating inflammatory process. Immunomodulatory treatment with pulse steroids resulted in rapid and dramatic clinical and radiographic improvement. Cerebral amyloid angiopathy-related inflammation should be considered in the differential diagnosis of new-onset seizures after the age of 40, when associated with fluctuating multifocal T2 hyperintensities and petechial hemorrhages on gradient echo (GRE) or susceptibility-weighted (SWI) MRI sequences...
2016: Epilepsy & Behavior Case Reports
Marta Drake-Pérez, Enrique Marco de Lucas, John Lyo, José L Fernández-Torre
PURPOSE: To describe the neuroimaging findings in subacute encephalopathy with seizures in alcoholics (SESA syndrome). METHODS: We reviewed all cases reported previously, as well as 4 patients diagnosed in our center. We included a total of 8 patients. All subjects had clinical and EEG findings compatible with SESA syndrome and at least one MRI study that did not show other underlying condition that could be responsible for the clinical presentation. RESULTS: Initial MRI studies revealed the following features: cortical-subcortical areas of increased T2/FLAIR signal and restricted diffusion (6 patients), hyperperfusion (3 patients), atrophy (5 patients), chronic microvascular ischemic changes (4 patients)...
August 2016: Seizure: the Journal of the British Epilepsy Association
J Yankam Njiwa, N Costes, C Bouillot, S Bouvard, S Fieux, G Becker, E Levigoureux, G Kocevar, C Stamile, J B Langlois, R Bolbos, C Bonnet, L Bezin, L Zimmer, A Hammers
Inflammation may play a role in the development of epilepsy after brain insults. [(11)C]-(R)-PK11195 binds to TSPO, expressed by activated microglia. We quantified [(11)C]-(R)-PK11195 binding during epileptogenesis after pilocarpine-induced status epilepticus (SE), a model of temporal lobe epilepsy.Nine male rats were studied thrice (D0-1, D0 + 6, D0 + 35, D0 = SE induction). In the same session, 7T T2-weighted images and DTI for mean diffusivity (MD) and fractional anisotropy (FA) maps were acquired, followed by dynamic PET/CT...
July 5, 2016: Journal of Cerebral Blood Flow and Metabolism
Ben Ridley, Marion Beltramone, Jonathan Wirsich, Arnaud Le Troter, Eve Tramoni, Sandrine Aubert, Sophie Achard, Jean-Philippe Ranjeva, Maxime Guye, Olivier Felician
Diagonistic dyspraxia (DD) is by far the most spectacular manifestation reported by sufferers of acute corpus callosum (CC) injury (so-called "split-brain"). In this form of alien hand syndrome, one hand acts at cross purposes with the other "against the patient's will". Although recent models view DD as a disorder of motor control, there is still little information regarding its neural underpinnings, due to widespread connectivity changes produced by CC insult, and the obstacle that non-volitional movements represent for task-based functional neuroimaging studies...
2016: Frontiers in Human Neuroscience
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