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Crossed Cerebellar Diaschisis in Status Epilepticus

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Abstract

Background

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).

Methods

Case report.

Results

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.

Conclusion

This case documents CCD during SE, providing further evidence of contralateral cerebellar involvement with a supratentorial epileptiform focus.

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Authors and Affiliations

  1. Stanford University, 701 Welch Road, Suite B 325, Palo Alto, CA, 94304, USA

    Edgar A. Samaniego, Erika Stuckert, Nancy Fischbein & Christine A. C. Wijman

Authors
  1. Edgar A. Samaniego
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  2. Erika Stuckert
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  3. Nancy Fischbein
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  4. Christine A. C. Wijman
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Corresponding author

Correspondence to Edgar A. Samaniego.

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Samaniego, E.A., Stuckert, E., Fischbein, N. et al. Crossed Cerebellar Diaschisis in Status Epilepticus. Neurocrit Care 12, 88–90 (2010). https://doi.org/10.1007/s12028-009-9312-y

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  • DOI: https://doi.org/10.1007/s12028-009-9312-y

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