Crossed Cerebellar Diaschisis in Status Epilepticus
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Crossed cerebellar diaschisis (CCD) has been reported on positron-emission tomography and single-photon emission computed tomography of stroke patients. Rarely it has been described with brain diffusion-weighted MRI (DWI) of status epilepticus (SE).
A 53-year-old woman was found unresponsive after cocaine use. A diagnostic electroencephalogram was consistent with ictal SE. A brain DWI showed reduced diffusion in the left temporo-parietal and occipital cortexes, the left thalamus and the right cerebellum. The DWI changes did not correspond to a vascular territory and were attributed to seizure activity and secondary CCD. A 2-week follow-up DWI showed interval near-complete resolution of the diffusion changes. CCD in SE may represent injury caused by excessive neuronal transmission from prolonged excitatory synaptic activity via the cortico-pontine-cerebellar pathway. Alternatively, it may be a result of interruption of the cortico-pontine-cerebellar pathway with loss of cortical inhibitory input.
This case documents CCD during SE, providing further evidence of contralateral cerebellar involvement with a supratentorial epileptiform focus.
- Komaba Y, et al. Crossed cerebellar diaschisis in patients with cortical infarction: logistic regression analysis to control for confounding effects. Stroke. 2004;35(2):472–6. CrossRef
- Baron JC, et al. “Crossed cerebellar diaschisis” in human supratentorial brain infarction. Trans Am Neurol Assoc. 1981;105:459–61.
- Gold L, Lauritzen M. Neuronal deactivation explains decreased cerebellar blood flow in response to focal cerebral ischemia or suppressed neocortical function. Proc Natl Acad Sci USA. 2002;99(11):7699–704. CrossRef
- Lauritzen M. Relationship of spikes, synaptic activity, and local changes of cerebral blood flow. J Cereb Blood Flow Metab. 2001;21(12):1367–83. CrossRef
- Lansberg MG, et al. MRI abnormalities associated with partial status epilepticus. Neurology. 1999;52(5):1021–7.
- Huang YC, et al. Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res. 2009.
- Calistri V, et al. Visualization of evolving status epilepticus with diffusion and perfusion MR imaging. AJNR Am J Neuroradiol. 2003;24(4):671–3.
- Szabo K, et al. Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain. 2005;128(Pt 6):1369–76. CrossRef
- Sakatani K, Iizuka H, Young W. Somatosensory evoked potentials in rat cerebral cortex before and after middle cerebral artery occlusion. Stroke. 1990;21(1):124–32.
- Buchkremer-Ratzmann I, et al. Electrophysiological transcortical diaschisis after cortical photothrombosis in rat brain. Stroke. 1996;27(6):1105–9. (discussion 1109–11).
- Crossed Cerebellar Diaschisis in Status Epilepticus
Volume 12, Issue 1 , pp 88-90
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press Inc
- Additional Links
- Crossed cerebellar diaschisis
- Status epilepticus
- Industry Sectors