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Arterial spin labeling hyperperfusion in seizures associated with non-ketotic hyperglycaemia: is it merely a post-ictal phenomenon?

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Abstract

A 53-year-old chronic uncontrolled diabetic patient presented with one episode of generalized seizures followed by drowsiness and post-ictal confusion. MR imaging at admission revealed left temporal subcortical T2/FLAIR hypointensities with overlying cortical T2/FLAIR hyperintensities and increased perfusion on arterial spin labeling (ASL). Follow-up imaging at 4- and 8-week interval revealed persistent ASL hyperperfusion with significant resolution of conventional MR imaging findings. Delayed persistent ASL hyperperfusion suggests that hyperglycemia-induced increased blood-brain barrier permeability rather than a mere post-ictal phenomenon in non-ketotic hyperglycemia (NKH) and may result in long-term cognitive disturbances.

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Authors and Affiliations

  1. Department of Imaging Sciences and Interventional Radiology, Sree chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India

    Sabarish Sekar, Selvadasan Vinayagamani, Bejoy Thomas & Chandrasekharan Kesavadas

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  1. Sabarish Sekar
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  2. Selvadasan Vinayagamani
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  3. Bejoy Thomas
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  4. Chandrasekharan Kesavadas
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Correspondence to Sabarish Sekar.

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Sekar, S., Vinayagamani, S., Thomas, B. et al. Arterial spin labeling hyperperfusion in seizures associated with non-ketotic hyperglycaemia: is it merely a post-ictal phenomenon?. Neurol Sci 42, 739–744 (2021). https://doi.org/10.1007/s10072-020-04815-6

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  • DOI: https://doi.org/10.1007/s10072-020-04815-6

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