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KMID : 1201420160090010025
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Journal of Neurocritical Care
2016 Volume.9 No. 1 p.25 ~ p.27
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Crossed Cerebellar Diaschisis in Convulsive Status Epilepticus
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Kim Shin-Yeop
Park Jung-A
Kim Ji-Eun
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Abstract
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Background: Status epilepticus (SE) may be associated with increased intensity in the cerebral cortex as observed on diffusion-weighted and fluid-attenuated inversion recovery magnetic resonance imaging (MRI). Rarely, this change in intensity also occurs in the contralateral cerebellum, although the pathophysiology of this phenomenon in epilepsy is not fully understood. Here, we present a case of crossed cerebellar diaschisis in convulsive status epilepticus and discuss the changes in serial MRI findings.
Case Report: A 48-year-old female patient was admitted to our hospital. She experienced an intermittent seizure every couple of months since infancy. One month before her admission, she discontinued the anticonvulsant medication by herself. On the admission day, she was found by her son in comatose mental status with a convulsive seizure involving the left side of the body. The seizure was controlled after administration of lorazepam and intravenous loading of levetiracetam. Brain MRI showed diffusion restriction in the right frontal lobe and left cerebellar hemisphere. The symptom of left hemiparesis persisted. Follow-up MRI was performed after 1 month, and it showed an atrophic change in the right hemisphere and diffuse cortical laminar necrosis with a mild atrophic change in the left cerebellar hemisphere.
Conclusion: Our case, which showed high intensity in the right cerebral hemisphere and the contralateral cerebellum on diffusion-weighted imaging, developed permanent cerebral and cerebellar damage.
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KEYWORD
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Status epilepticus, Crossed cerebellar diaschisis, Magnetic resonance imaging
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