JLE

Epileptic Disorders

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Atypical postictal transient subcortical T2 hypointensity in a newly diagnosed diabetic patient with seizures Volume 20, issue 3, June 2018

Figure 1

EEG: (A) standard 10-20 system EEG recording showing an epileptic discharge consisting of rhythmic theta activity arising from the right temporal leads. Fifteen seconds later, the discharge evolved in frequency from theta (6-Hz) to delta waves with superimposed sharply contoured waves in the right temporal region only. Two minutes later, the discharge continued, spreading over the ipsilateral and contralateral leads and slowing in the range of delta frequencies. There were no clinical concomitants. Two minutes and 48 seconds later, 8-Hz alpha activity with superimposed theta frequencies reappeared at the same leads where the epileptic discharge had occurred. (B) One-month follow-up EEG showing normal findings.

Figure 2

(A-D) Baseline MRI axial T2w with RL phase encoding (A), AP phase encoding (B), DWI b1000 (C), and FLAIR (D), showing right temporal subcortical hypointensity (arrows). (E, F) Follow-up MRI shows resolution of T2w hypointensity, with only a residual juxtacortical gliotic focus: axial T2w with RL phase encoding (E) and FLAIR (F). Images are shown in radiologic view (the right side of the brain is on the left side).