Fig. 24

Status epilepticus. A 30-year-old woman with epilepsy quit her anti-epileptic treatment during pregnancy and was brought to the hospital in status epilepticus. Coronal T2W (a) and axial FLAIR images (b) in the acute phase show extensive cortical oedema in the right temporal lobe with involvement of the right hippocampus as well as in the right insula. There was no diffusion restriction or contrast enhancement (images not shown). Control MRI performed 4 days later after initiation of anti-epileptic treatment shows regression of the oedema on axial FLAIR (c). On follow-up MRI performed one month later, axial FLAIR shows volume loss of the right hippocampus as well as increased signal intensity, reflecting secondary gliotic changes (d). Alternatively, this could also be a preexistent mesial temporal sclerosis. As extensive clinical work-up revealed no other possible cause for the observed cortical oedema, final diagnosis was seizure-induced cortical edema