Neurology Trainee Princess Alexandra Hospital Brisbane, Queensland, Australia
Rationale: Imaging findings in the context of prolonged seizures and status epilepticus can result in diagnostic uncertainty as it can be difficult to determine if these abnormalities are the cause of seizure or if the changes occur as a result of seizures. We aimed to determine the frequency of MRI abnormalities after admission for seizure and the proportion of these changes which resolved after seizure treatment. Methods: A retrospective review of all cases presenting with seizures between 2011 – 2019 was performed. Cases were included if an MRI was performed after admission and if there was a repeat scan after seizure treatment. Results: Two hundred forty cases were reviewed and 121 included. Ninety-nine cases (81.8%) had MRI abnormalities on the initial MRI after admission and in 26 (21.4%) cases these abnormalities had resolved on the second MRI after seizure treatment. Resolution of MRI changes correlated with presentations of status epilepticus (p=0.006) and prolonged duration of seizure (p=0.04). The most common reversible MRI abnormalities were FLAIR changes (100% of cases, p=0.0001). Diffusion restriction on DWI also occurred in 36% of these cases. Conclusions: MRI abnormalities in patients admitted with seizures were common and some of them resolved after seizure treatment. These findings suggest that prolonged seizures and status epilepticus might result in local injury that is visible as changes on MRI, that can improve after administration of anti-seizure therapy. This is particularly true of FLAIR changes. Funding: Please list any funding that was received in support of this abstract.: Nil.
