Background

Transient periictal MRI abnormalities (TPMA) are caused by seizures, and may completely or partially reverse within a few days following seizure. Although TPMA are usually observed in patients with status epilepticus (SE), they have also been rarely reported after isolated/recurrent seizures not fulfilling the criteria for SE. Herein, we present a case of a 1-year-old girl with TPMA.

Case

A 1-year-old girl with Apert syndrome and epilepsy showed MRI abnormalities in the cortico-subcortical areas of the left temporal, occipital and parietal lobes, as well as the left thalamus. These abnormalities showed as a hyperintense signal on diffusion-weighted imaging and a hypointense signal on apparent-diffusion coefficient maps. On follow-up MRI after 3 days, the abnormal signals were completely reversed. We confirmed TPMA after eliminating other possibilities. When treatment was withdrawn, the patient regained consciousness immediately and did not show any abnormality on subsequent MRI.

Conclusion

TPMA may occur in young children; recognizing this possibility is important for making the diagnosis and conducting appropriate treatment. As a previous study revealed, the distribution of signal changes in cortico-subcortical areas and the ipsilateral thalamus may be a characteristic feature of TPMA.

中文翻译：

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反复癫痫发作后一例一过性发作期 MRI 异常的儿科病例

背景

短暂的发作期 MRI 异常 (TPMA) 是由癫痫发作引起的，并且可能在癫痫发作后的几天内完全或部分逆转。虽然 TPMA 通常在癫痫持续状态 (SE) 患者中观察到，但在不符合 SE 标准的孤立性/复发性癫痫发作后也很少报告。在此，我们介绍一个 1 岁女孩患有 TPMA 的病例。

案件

一名患有 Apert 综合征和癫痫的 1 岁女孩，其左侧颞叶、枕叶和顶叶以及左侧丘脑的皮质-皮质下区域的 MRI 异常。这些异常表现为弥散加权成像上的高信号和表观弥散系数图上的低信号。3天后复查MRI，异常信号完全逆转。在排除其他可能性后，我们确认了 TPMA。停止治疗后，患者立即恢复意识，随后的 MRI 检查未见任何异常。

结论

TPMA 可能发生在幼儿身上；认识到这种可能性对于做出诊断和进行适当的治疗很重要。正如之前的一项研究所揭示的，皮质-皮质下区域和同侧丘脑的信号变化分布可能是 TPMA 的一个特征。