The reversible focal MRI abnormalities in complex partial seizure: technical instruction

Abstract

Case report. A 17-month-old infant girl was admitted with complex partial seizures and right side hemiparesis. Five days after the last seizure, MR signal changes were observed in the left hemisphere with a cavernous hemangioma in the middle temporal gyrus. However, these MR signal changes had normalized 11 days after the last seizure, except for the cavernous hemangioma. The scalp EEG findings revealed that the epileptic focus was on the mid-temporal gyrus. The patient underwent lesionectomy only. Two months after this operation the MR showed no signal abnormality. Throughout a 12-month follow-up after surgery the patient remained seizure free.

Discussion. MR signal changes in seizure patients do not always indicate the structural region concerned, but can be transient signal changes. They may be due to the propagation of epileptic discharge along the association fiber from the seizure focus. However, transient signal changes after seizure must be followed up to allow exclusion of a tumor and other diseases.