Reversible MRI abnormalities associated with prolonged seizure
Abstract number :
102
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2020
Submission ID :
2422450
Source :
www.aesnet.org
Presentation date :
12/5/2020 9:07:12 AM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Dan Truong, Princess Alexandra Hospital; Lisa Gillinder - Princess Alexandra Hospital; Cullen O'Gorman - Princess Alexandra Hospital;;
Rationale:
Imaging findings in the context of prolonged seizures and status epilepticus can result in diagnostic uncertainty as it can be difficult to determine if these abnormalities are the cause of seizure or if the changes occur as a result of seizures. We aimed to determine the frequency of MRI abnormalities after admission for seizure and the proportion of these changes which resolved after seizure treatment.
Method:
A retrospective review of all cases presenting with seizures between 2011 – 2019 was performed. Cases were included if an MRI was performed after admission and if there was a repeat scan after seizure treatment. Results240 cases were reviewed and 121 included. 99 cases (81.8%) had MRI abnormalities on the initial MRI after admission and in 26 (21.4%) cases these abnormalities had resolved on the second MRI after seizure treatment. Resolution of MRI changes correlated with presentations of status epilepticus (p=0.006) and prolonged duration of seizure (p=0.04). The most common reversible MRI abnormalities were FLAIR changes (100% of cases, p=0.0001). Diffusion restriction on DWI also occurred in 36% of these cases.
Conclusion:
MRI abnormalities in patients admitted with seizures were common and some of them resolved after seizure treatment. These findings suggest that prolonged seizures and status epilepticus might result in local injury that is visible as changes on MRI, that can improve after administration of anti-seizure therapy. This is particularly true of FLAIR changes.
Funding:
:Nil.
Neuro Imaging