Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 30, 2015
Postictal Signal Changes
- Key Diagnostic Features:
- CT: transient focal decreased gyral or hippocampal attenuation
- MRI: transient increased signal on FLAIR and T2WI (most common in the frontal and parietal lobes but also seen in the temporal and occipital lobes)
- Reversible diffusion restriction and abnormal cortical enhancement has been reported.
- These findings presumably reflect postictal changes induced by seizure.
- DDx:
- Limbic encephalitis
- Hypoglycemia and other toxic-metabolic etiologies
- Heat stroke
- Ischemia, including transient global amnesia
- Venous sinus thrombosis
- Rx: Medical management according to seizures etiology
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