Updates in Refractory Status Epilepticus

Figure 5

Selected MRI images from a woman with a new-onset focal refractory status epilepticus of the left temporal region. (a) A FLAIR image shows an increased signal involving the cortical gray matter with swelling of gyri of the temporal lobe, occipital lobe, and insula (thin white arrows in (a)). There are also areas of subcortical white matter hyperintensity (thick white arrow in (a)) and distal abnormality involving the posterior thalamus (pulvinar) (asterisk in (a)). (b) An axial postcontrast T1W image shows gyriform enhancement of the same region as FLAIR abnormalities (black arrows in (b)). (c) A diffusion-weighted image (DWI) shows an increased signal (black arrowheads in (c)). (d) An ADC map image shows decreased attenuation in the same region (white arrowheads in (d)) as DWI abnormalities suggestive of cytotoxic edema.

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