FOCAL CEREBRAL MAGNETIC-RESONANCE CHANGES ASSOCIATED WITH PARTIAL STATUS EPILEPTICUS

We report 2 patients with transient abnormalities on magnetic resonanc e imaging (MRI) associated with partial status epilepticus (SE). A man with a 4-month history of partial seizures had complex partial SE for 9 days, with left temporal maximum on ictal EEG. Left temporal lobe T -2 signal was increased on MRI during SE, but cerebral MRI was normal 9 weeks later. A woman with ''cryptogenic'' temporal lobe epilepsy for 16 years had complex partial SE for 1 week, with right temporal maxim um on ictal EEG. T-2 Signal was increased over the entire right tempor al lobe, extending into the insula, without mass effect, on MRI 1 mont h after SE ended. Repeat MRI 1 month later showed marked decrease in v olume of increased T-2 intensity, without gadolinium enhancement, but with mild mass effect over the right anteroinferomesial temporal areas . A gemistocytic astrocytoma was resected. Focal cerebral MRI abnormal ities consistent with cerebral edema may be due to partial SE but also may indicate underlying glioma, even in long-standing partial epileps y. Focal structural imaging changes consistent with neoplasm should be followed to full resolution after partial SE.