癲癇發作後腦信號改變

來自：雙語學影像；本期病例選自AJNR Case of the Week

A 35-year-old man with change in mental status following seizures

35歲男性，癲癇發作後精神異常。

T2 GRE:

axial FLAIR:

One-week follow-up T2-FLAIR:

Axial DWI (A), T2 GRE (B), and axial FLAIR (C) R sequences demonstrate bilateral symmetric hippocampal restricted diffusion with no signs of hemorrhage and associated increased T2 signal and mild swelling. One-week follow-up T2-weighted FLAIR MR sequence (D) demonstrates resolution of the T2W signal abnormality.

橫斷位DWI、T2 GRE、FLAIR序列示：雙側海馬區對稱性彌散受限，未見明顯出血灶，T2WI見海馬區輕度水腫、呈稍高信號。

1周後複查，T2-FLAIR序列示海馬區異常信號消失。

Postictal Signal Changes

癲癇發作後腦信號改變

Key Diagnostic Features

• CT: transient focal decreased gyral or hippocampal attenuation

  CT:海馬或腦回一過性密度減低。
  

• 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)

  MRI：T2WI及FLAIR一過性信號增高（常見於額、頂葉，也可見於顳葉和枕葉）
  

• Reversible diffusion restriction and abnormal cortical enhancement has been reported.

  有文獻報導，病灶彌散受限，並可見皮層區異常強化。

• These findings presumably reflect postictal changes induced by seizure.

  這些表現可能與癲癇發作後的改變有關。

Rx

Medical management according to seizures etiology

針對癲癇病因藥物治療

播放GIF