The use of susceptibility-weighted imaging for epileptic focus localization in acute-stage pediatric encephalopathy: a case report

Pediatr Neurol. 2014 Feb;50(2):171-6. doi: 10.1016/j.pediatrneurol.2013.09.004. Epub 2013 Nov 19.

Abstract

Background: Susceptibility-weighted imaging is a novel high-spatial-resolution three-dimensional gradient-echo magnetic resonance imaging technique with phase postprocessing that accentuates the paramagnetic properties of blood products. The use of susceptibility-weighted imaging for epileptic focus localization in the acute stage of encephalopathy in a child has not been documented.

Patients: We report three pediatric patients with status epilepticus in the setting of fever, in whom susceptibility-weighted imaging showed transient prominence of the focal venous vasculature.

Results: Conventional cranial T1- and T2-weighted images and diffusion-weighted images showed no abnormalities. The prominence of the focal venous vasculature in these patients, as demonstrated by susceptibility-weighted imaging, was consistent with the epileptic focuses suggested by both clinical symptoms and electroencephalograph findings and resolved completely without neurological sequelae in all patients.

Conclusions: Susceptibility-weighted imaging may facilitate assessing epileptic focus localization in the acute stage of encephalopathy in children.

Keywords: child; encephalopathy; febrile seizure; status epilepticus; susceptibility-weighted imaging.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Brain / pathology*
  • Brain / physiopathology
  • Child
  • Child, Preschool
  • Diffusion Magnetic Resonance Imaging
  • Electroencephalography
  • Encephalitis, Viral / pathology
  • Encephalitis, Viral / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Roseolovirus Infections / pathology
  • Roseolovirus Infections / physiopathology
  • Seizures, Febrile / pathology
  • Seizures, Febrile / physiopathology
  • Status Epilepticus / pathology*
  • Status Epilepticus / physiopathology

Supplementary concepts

  • Human Herpesvirus 6 encephalitis