Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

MRI arterial spin labeling is useful for diagnosing recovery from nonconvulsive status epilepticus with sustained periodic discharges

Satoshi Saito, M.D.1), Mutsumi Iijima, M.D., Ph.D.1), Misa Seki, M.D., Ph.D.1), Hiroshi Yoshizawa, M.D., Ph.D.1) and Kazuo Kitagawa, M.D., Ph.D.1)

1) Department of Neurology, Tokyo Women's Medical University School of Medicine

A 75-year-old man with a history of temporal lobe epilepsy (treated with levetiracetam) was transferred to our hospital because of loss of consciousness. At admission, he was drowsy and exhibited myoclonus on the left side of face. We established a diagnosis of status epilepticus and started treatment with levetiracetam, fosphenytoin, and midazolam. FLAIR and DWI showed hyperintensity in the right cerebral cortex. Electroencephalography (EEG) showed lateralized periodic discharges (LPDs) at the right hemisphere, indicative of non-convulsive status epilepticus (NCSE). He regained consciousness after treatment with anti-epileptic drugs but showed persistent LPDs in EEG. MRI arterial spin labeling (ASL) showed normal perfusion in the right hemisphere; therefore, he was deemed to have recovered from status epilepticus and transferred to the rehabilitation hospital. MRI ASL is useful for diagnosing recovery from NCSE irrespective of sustained periodic discharges on EEG.
Full Text of this Article in Japanese PDF (2587K)

(CLINICA NEUROL, 62: 49−52, 2022)
key words: nonconvulsive status epilepticus, periodic discharges, arterial spin labeling

(Received: 4-May-21)