Advertisement

Neurological Sciences

, Volume 40, Issue 4, pp 851–855 | Cite as

Subcortical axonal loss with glial reactions following partial status epilepticus with neuroradiological findings of reduced subcortical diffusion

  • Sooyoung LeeEmail author
  • Takato Morioka
  • Pin Fee Chong
  • Satoshi O. Suzuki
  • Toru Imagi
  • Nobuya Murakami
  • Hiroshi Baba
  • Ryutaro Kira
Brief Communication
  • 145 Downloads

Abstract

Hyperintensity in the subcortical white matter on the diffusion-weighted magnetic resonance image has been described recently, in association with partial status epilepticus. Although this reduced subcortical diffusion is typically seen in patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), the exact pathophysiological mechanism is unclear. We report the case of a 3-month-old boy who underwent surgery for intractable epilepsy associated with cortical dysplasia in the left peri-Rolandic area, coincident with the appearance of reduced subcortical diffusion. Neurohistological findings revealed that the most prominent finding was axonal loss with marked astroglial and microglial reactions in the white matter. Neither degenerated neurons nor neurophagocytic microglial accumulation was evident in the cortex. These findings confirm that white matter can be secondarily damaged in patients with partial status epilepticus, and possible pathomechanism of reduced subcortical diffusion is discussed.

Keywords

Bright tree appearance Astroglia Microglia Partial status epileptics 

Notes

Acknowledgments

We thank Drs. Masaru Matsukura, Ryoko Nakamura, and Kenichi Maeda, Department of Pediatric Neurology, Fukuoka Children’s Hospital, for supporting the study.

Funding information

This research was supported in part by Fukuoka Children’s Hospital Research Fund.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Consents

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Takanashi J, Oba H, Barkovich AJ, Tada H, Tanabe Y, Yamanouchi H, Fujimoto S, Kato M, Kawatani M, Sudo A, Ozawa H, Okanishi T, Ishitobi M, Maegaki Y, Koyasu Y (2006) Diffusion MRI abnormalities after prolonged febrile seizures with encephalopathy. Neurology 66:1304–1309CrossRefGoogle Scholar
  2. 2.
    Miki Y, Tanji K, Mori F et al (2017) Status epilepticus causing extensive microvascular change with astrocytosis and diffusion MRI abnormalities in the subcortical white matter. J Neurol Sci 382:55–57CrossRefGoogle Scholar
  3. 3.
    Fujita Y, Takanashi J, Takei H, Ota S, Fujii K, Sakuma H, Hayashi M (2016) Activated microglia in acute encephalaopahty with biphasic seizures and late reduced diffusion. J Neurol Sci 366:91–93CrossRefGoogle Scholar
  4. 4.
    Morioka T, Nishio S, Ishibashi H, Muraishi M, Hisada K, Shigeto H, Yamamoto T, Fukui M (1999) Intrinsic epileptogenicity of focal cortical dysplasia as revealed by magnetoencephalography and electrocorticography. Epilepsy Res 33:177–187CrossRefGoogle Scholar
  5. 5.
    Shimogawa T, Morioka T, Sayama T, Haga S, Kanazawa Y, Murao K, Arakawa S, Sakata A, Iihara K (2017) The initial use of arterial spin labeling perfusion and diffusion-weighted magnetic resonance images in the diagnosis of nonconvulsive partial status epilepticus. Epilepsy Res 129:162–173CrossRefGoogle Scholar
  6. 6.
    Matute C (2011) Glutamate and ATP signalling in white matter pathology. J Anat 219:53–64CrossRefGoogle Scholar
  7. 7.
    Trendelenburg G, Dirnagl U (2005) Neuroprotective role of astrocytes in cerebral ischemia: focus on ischemic preconditioning. Glia 51:307–320CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Intensive CareFukuoka Children’s HospitalFukuokaJapan
  2. 2.Department of NeurosurgeryFukuoka Children’s HospitalFukuokaJapan
  3. 3.Department of Pediatric NeurologyFukuoka Children’s HospitalFukuokaJapan
  4. 4.Department of Neuropathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  5. 5.Department of Neurosurgery, Epilepsy Center, Nishiisahaya HospitalIsahayaJapan

Personalised recommendations