Journal List > J Korean Radiol Soc > v.42(3) > 1068836

J Korean Radiol Soc. 2000 Mar;42(3):411-416. Korean.
Published online March 11, 2016.
Copyright © The Korean Radiological Society
MR Imaging Findings of Generalized Tonic Clonic Seizure Induced Brain Changes
Jeong Ah Kim, Jin Il Chung, Pyeong Ho Yoon, Dong Ik Kim, Tae Sub Chung and Joo Hee Kim
Department of Diagnostic Radiology, College of Medicine, Yonsei University, Radiological Institute of Radiological Science.

PURPOSE: To evaluate MRI signal changes in the brain induced by generalized tonic clonic seizure. MATERIALS AND METHODS: Six patients who underwent MRI within three days of generalized tonic clonic seizure were retrospectively reviewed. Diffusion-weighted images were added in three patients during initial exami-nation, and in six, the follow-up MRI was performed nine days to five months after the onset of seizure. We evaluated the patterns of signal change, location of the lesion and degree of contrast enhancement, and the signal change seen on diffusion weighted images. We also compared the signal changes seen on initial and follow-up MRI. RESULTS: In all six patients, MR images showed focally increased T2 signal intensity, and swelling and increased volume of the involved cortical gyrus. In five, the lesion was mainly located in the cortical gray matter and subcortical white matter; namely, in the bilateral cingulate gyri, and the bilateral parieto-occipital, left parietal, left frontoparietal, and left temporal lobe. In the remaining patient, the lesion was located in the right hippocampus. Two patients showed bilateral lesions and one showed multiple lesions. In four patients, T1- weighted images revealed decreased signal intensity of the same location, and in one, gyral contrast enhancement was noted. On diffusion-weighted images, three patients showed increased signal intensity. Follow-up MRI demonstrated complete resolution of the abnormal signal change (n=5), or a decrease(n=1). CONCLUSION: A transient increase in MR signal intensity with increased volume was noted in cortical and subcortical white matter after generalized tonic clonic seizure. This finding reflects the vasogenic and cytotoxic edema induced by seizure and can help exclude etiologic lesions such as tumors, inflammation and demyelinating disease that induce epilepsy.

Keywords: Brain, edema; Magnetic resonance (MR)diffusion; Epilepsy