IRREVERSIBLE BRAIN-LESIONS FOLLOWING PART IAL CONVULSIVE STATUS EPILEPTICUS - A CLINICAL, NEURORADIOLOGICAL AND PET STUDY

An 11-year-old girl developed signs of intracranial hypertension after status epilepticus with convulsive movements of her right upper limb. Computerized tomography revealed left hemispheric hypodensity with ma ss effect, attributed to vasogenic edema. Intracranial hypertension wa s controlled under intracranial pressure monitoring and clinical statu s slowly improved. The patient was aphasic and right hemiplegic when s he recovered consciousness but she remarkably recovered from her neuro logical deficits during the following two years despite neuroradiologi cal evolution demonstrating extensive destruction of the left cortex a nd white matter. Two positron emission tomography (PET) scans were per formed respectively six weeks and eight months after status epilepticu s, and both demonstrated profound left hemispheric hypometabolism exce pt in the lenticular nucleus and a restricted area of motor/premotor c ortex. On the other hand, glucose metabolism in the right hemisphere w as heterogenlously increased on the second PET when compared with the first PET. We concluded that, in this case, clinical recovery might ha ve implicated functional reorganization arising from the intact hemisp here.