Unilateral cerebral hemisphere oedema as a peri-ictal phenomenon
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Focal peri-ictal abnormalities on cerebral imaging are well described , most commonly mimicking tumours [2, 5]. More extensive abnormalities resembling cerebral ischaemia are more rarely described. Here we describe a case of extensive peri-ictal cerebral oedema.
A 37 year-old man with a known craniopharyngioma and secondary epilepsy presented following a cluster of tonic-clonic seizures occurring over the course of a day. At the time of admission he was experiencing generalised tonic-clonic seizures every 10 min. He was apyrexial and normotensive. Neurological examination showed right-sided hemiparesis, right hemianopia and dysphasia. His white blood cell count and C reactive protein were normal. Treatment with phenytoin and lorazepam resulted in resolution of his seizures.
He had been diagnosed with craniopharyngioma at the age of 20 when he presented with a 4-year history of partial seizures manifesting as vacant episodes or right arm focal motor jerks. MRI scan at the...
KeywordsApparent Diffusion Coefficient Status Epilepticus Topiramate Diffusion Weighted Imaging Partial Seizure
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