A case of nonconvulsive status epilepticus with a reversible contralateral cerebellar lesion: temporal changes in magnetic resonance imaging and single-photon emission computed tomography finding

J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e639-42. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.015. Epub 2013 Jul 30.

Abstract

A 67-year-old woman was brought to our institution because of unconsciousness. Clinical and electrophysiological findings lead us to diagnose her with nonconvulsive status epilepticus. Initial magnetic resonance imaging revealed hyperintensity in the left cerebral cortex and the right cerebellum on diffusion-weighted image and fluid-attenuated inversion recovery (FLAIR). Single-photon emission computed tomography showed increased blood flow in the left frontal cerebrum but not in the right cerebellum. The hyperintensity in the left cerebrum on the follow-up FLAIR was still present. The contralateral cerebellum remained undamaged even though the blood flow was not increased in this region because the excitotoxicity there was far lesser than that in the cerebrum.

Keywords: Blood flow; crossed cerebellar diaschisis; magnetic resonance imaging; nonconvulsive status epilepticus; single-photon emission computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticonvulsants / therapeutic use
  • Brain Waves
  • Cerebellum / blood supply*
  • Cerebellum / diagnostic imaging
  • Cerebellum / physiopathology
  • Cerebrovascular Circulation*
  • Diffusion Magnetic Resonance Imaging*
  • Electroencephalography
  • Female
  • Humans
  • Levetiracetam
  • Perfusion Imaging / methods*
  • Piracetam / analogs & derivatives
  • Piracetam / therapeutic use
  • Predictive Value of Tests
  • Status Epilepticus / diagnosis*
  • Status Epilepticus / diagnostic imaging
  • Status Epilepticus / drug therapy
  • Status Epilepticus / physiopathology
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam