2013 Volume 30 Issue 3 Pages 496-503
MRI could visualize epileptic foci, but few studies successfully delineated their propagation. We reported two patients with status epilepticus showing transient symmetrical high intensity area (HIA) by diffusion weighed image (DWI) in each hemisphere. The first patient was a 52-y-o woman, having treated for schizophrenia. She had generalized tonic-clonic seizure. Her generalized seizures frequently occurred up to eight times per hour for three days. Her EEG during status showed BIPLEDs. Her MRI study indicated symmetrical HIAs in the bilateral frontal lobes. The second patient was a 61-y-o man admitted for loss of consciousness. After generalized tonic seizure occurred delirium sustained for several hours. His EEG showed continuous slow waves regional in the right front-temporal area. His MRI study indicated HIAs in the bilateral frontal lobes and an old lobar infarction in the right temporal lobe. It suggested that his seizure arose from the right temporal lobe with secondarily generalization or propagation to the bilateral frontal lobes. The HIAs by DWI observed in both patients finally disappeared. EEGs became normal after anticonvulsant treatment. These transient abnormal MRI findings possibly reflected both seizure foci and the propagated areas via corpus callosum caused by excessive cellular excitation.
