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Focal Thalamic and Cortical Magnetic Resonance Changes Associated With Partial Status Epilepticus

Status epilepticus (SE) is a commonly occurring life-threatening neurological emergency. Magnetic resonance imaging (MRI) may provide insight into the pathophysiological processes implicated in SE and unique MRI patterns associated with partial SE have recently been reported. We describe transient signal changes on MRI in the areas of cortex and thalamus both ipsilateral to the ictal discharges on electroencephalogram (EEG) in a selected group of five patients with partial SE. We believe this pattern is specific to the peri-ictal state and its recognition is important in those cases where the diagnosis of SE is uncertain. We discuss other common MRI findings seen in SE and possible reasons for similar patterns of corticothalamic signal changes in patients with varying etiologies for SE. The determination of the sensitivity and specificity of such an imaging finding for partial SE still requires further large-scale studies, but a correct recognition of these often reversible imaging abnormalities may help to avoid unnecessary diagnostic tests and invasive procedures.  doi:10.4021/jnr69w