抄録
We report that serial diffusion weighted imaging (DWI) is clinically useful in an epilepsy patient. A 63-year-old man was admitted in an emergency with status epilepticus and consciousness disturbance. CT scan and conventional MRI showed no abnormal area. DWI revealed the focal lesion as high intensity area in the parietooccipital area. Also, periictal EEG showed a focal epileptiform discharge in the same area. DWI was repeated for 5 consecutive days. The size of high intensity area seen on DWI decreased day by day. It therefore seemed reasonable to conclude that the high intensity area in the DWI in this case was the epileptogenic focus. The change in DWI findings in epilepsy is similar to the findings in cerebral ischemia. However, the mechanisms resulting in these finding may be different from those associated with ischemia. In status epilepticus, the metabolism is markedly increased, resulting in depletion of energy reserves in the later stage. This will result in impaired ion exchange pump functions and swelling of neuronal and glial cells. Serial DWI can be useful diagnostic method for localization of the focus in the evaluation of cases with epilepsy.
