TABLE 2.
Clinical Information, EEG Pattern, and Outcome in 16 Patients With Acute Cortical Imaging Abnormalities
| Pt | Age, y | Etiology | Initial Imaging | Followup MRI (≥2 wk) | EEG | Outcome |
|---|---|---|---|---|---|---|
| 1 | 3 | Acute renal failure | CT diffuse cerebral edema | Bilateral hippocampal atrophy a | R temporal δ (NCSE) | Continued seizures, no deficits |
| 2 | 1 | Prematurity and perinatal IVH | MRI DWI restriction L hemisphere | Diffuse cortical necrosis L hemisphere a | L frontal α (NCSE) | R hemiparesis |
| 3 | 0.8 | Unknown | MRI R posterior FLAIR signal | Severe global brain atrophy a | L rhythmic δ/α (NCSE) | Developmental arrest |
| 4 | 0.5 | Systemic infection, hypoxia | MRI diffuse cerebral edema | None | Multifocal spike and wave (NCSE) | Death |
| 5 | 8 | Cardiopulmonary arrest | CT diffuse cerebral edema | None | R > L independent seizures (NCSE) | Death |
| 6 | 9 | Fever | MRI multifocal cortical signal | Increasing areas of signal abnormality | 1–2 Hz rhythmic δ (NCSE) | Progression of neurologic dysfunction |
| 7 | 3 | PRES | MRI multifocal cortical signal | Increasing periventricular signal | Rhythmic α/β (NCSE) | Death |
| 8 | 5 | No acute etiology, chromosomal anomaly | MRI FLAIR signal bilateral posterior | None | No seizures | No deficits |
| 9 | 21 | Fever | CT decreased gray-white differentiation occipital lobes | None | Diffuse rhythmic β (NCSE) | No deficits |
| 10 | 6 | Fever/known TS | MRI multifocal DWI change in cortical areas corresponding to known tubers | Diffuse cortical atrophy a | Bilateral posterior (NCSE) | Cognitive morbidity, motor disability |
| 11 | 2 | Anoxic injury | MRI diffuse cortical edema and white matter DWI restriction | None | L frontal temporal δ/θ (NCSE) | Severe neurologic impairment |
| 12 | 19 | Meningitis | MRI multifocal signal abnormality | MRI cortical atrophy a | No seizures | No deficits |
| 13 | 4 | Anoxic injury | CT diffuse cortical edema | None | No seizures | Death |
| 14 | 11 | Unknown inflammatory CNS process | MRI R cerebral FLAIR signal | None | R hemisphere slowing, no seizures | No deficits |
| 15 | 16 | Unknown, resected medulloblastoma | MRI bilateral temporal lobe signal | None | R posterior rhythmic θ | No deficits |
| 16 | 2 | Multiorgan failure | MRI multifocal cortical signal | None | No seizures | Death |
CNS, central nervous system; DWI, diffusion weighted imaging; FLAIR, fluid attenuated inversion recovery; IVH, intraventricular hemorrhage; PRES, posterior reversible leukoencephalopathy syndrome; TS, tuberous sclerosis.
a
Evidence of resulting brain atrophy on follow-up MRI was seen in 5 patients.