Abstract
Magnetic resonance perfusion imaging with arterial spin labeling (ASL) can provide valuable information on the circulatory changes associated with status epilepticus (SE). We report a case of a girl with an old brain abscess in the right frontal lobe who developed secondary generalized SE twice (at 3 and 4 years of age). Although she made a full recovery after the first SE, she developed acute encephalopathy with reduced subcortical diffusion (AED) following the second SE with a monophasic clinical course. We compared the ASL findings on day 4 after onset of each SE. After the first SE, ASL revealed postictal hypoperfusion in bilateral anterior circulation territories. By contrast, after the second SE, there was a marked increase in ASL signals of the entire cortex, particularly in the right fronto-parietal lobe, which corresponded to the area of reduced subcortical diffusion. Prolonged cortical hyperperfusion may have caused relative ischemia of the subcortex. As there is growing evidence that oligodendrocytes are selectively vulnerable to ischemia via glutamatemediated excitotoxicity, our findings suggest that white matter ischemia may cause axonal injury in this case. Finding of prolonged cortical ASL hyperperfusion around day 4 after SE onset may be important for the detection of reduced subcortical diffusion.
| Original language | English |
|---|---|
| Pages (from-to) | 32-39 |
| Number of pages | 8 |
| Journal | Epilepsy and Seizure |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2017 |
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All Science Journal Classification (ASJC) codes
- Clinical Neurology
Cite this
Perfusion imaging with arterial spin labeling in acute encephalopathy with reduced subcortical diffusion following secondary generalized status epilepticus. / Takahara, Kenta; Morioka, Takato; Shimogawa, Takafumi; Amano, Toshiyuki; Kawakita, Aoi; Watanabe, Kyoko; Haga, Sei.
In: Epilepsy and Seizure, Vol. 9, No. 1, 01.01.2017, p. 32-39.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Perfusion imaging with arterial spin labeling in acute encephalopathy with reduced subcortical diffusion following secondary generalized status epilepticus
AU - Takahara, Kenta
AU - Morioka, Takato
AU - Shimogawa, Takafumi
AU - Amano, Toshiyuki
AU - Kawakita, Aoi
AU - Watanabe, Kyoko
AU - Haga, Sei
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Magnetic resonance perfusion imaging with arterial spin labeling (ASL) can provide valuable information on the circulatory changes associated with status epilepticus (SE). We report a case of a girl with an old brain abscess in the right frontal lobe who developed secondary generalized SE twice (at 3 and 4 years of age). Although she made a full recovery after the first SE, she developed acute encephalopathy with reduced subcortical diffusion (AED) following the second SE with a monophasic clinical course. We compared the ASL findings on day 4 after onset of each SE. After the first SE, ASL revealed postictal hypoperfusion in bilateral anterior circulation territories. By contrast, after the second SE, there was a marked increase in ASL signals of the entire cortex, particularly in the right fronto-parietal lobe, which corresponded to the area of reduced subcortical diffusion. Prolonged cortical hyperperfusion may have caused relative ischemia of the subcortex. As there is growing evidence that oligodendrocytes are selectively vulnerable to ischemia via glutamatemediated excitotoxicity, our findings suggest that white matter ischemia may cause axonal injury in this case. Finding of prolonged cortical ASL hyperperfusion around day 4 after SE onset may be important for the detection of reduced subcortical diffusion.
AB - Magnetic resonance perfusion imaging with arterial spin labeling (ASL) can provide valuable information on the circulatory changes associated with status epilepticus (SE). We report a case of a girl with an old brain abscess in the right frontal lobe who developed secondary generalized SE twice (at 3 and 4 years of age). Although she made a full recovery after the first SE, she developed acute encephalopathy with reduced subcortical diffusion (AED) following the second SE with a monophasic clinical course. We compared the ASL findings on day 4 after onset of each SE. After the first SE, ASL revealed postictal hypoperfusion in bilateral anterior circulation territories. By contrast, after the second SE, there was a marked increase in ASL signals of the entire cortex, particularly in the right fronto-parietal lobe, which corresponded to the area of reduced subcortical diffusion. Prolonged cortical hyperperfusion may have caused relative ischemia of the subcortex. As there is growing evidence that oligodendrocytes are selectively vulnerable to ischemia via glutamatemediated excitotoxicity, our findings suggest that white matter ischemia may cause axonal injury in this case. Finding of prolonged cortical ASL hyperperfusion around day 4 after SE onset may be important for the detection of reduced subcortical diffusion.
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UR - http://www.scopus.com/inward/citedby.url?scp=85028987091&partnerID=8YFLogxK
U2 - 10.3805/eands.9.32
DO - 10.3805/eands.9.32
M3 - Article
AN - SCOPUS:85028987091
VL - 9
SP - 32
EP - 39
JO - Epilepsy and Seizure
JF - Epilepsy and Seizure
SN - 1882-5567
IS - 1
ER -