Periictal diffusion-weighted imaging in a case of lesional epilepsy

Purpose: Diffusion-weighted MR imaging (DWI) has been used for the early di agnosis of acute ischemic lesions in humans and in animal models of focal s tatus epilepticus. We hypothesized that DWI may be a sensitive, noninvasive tool for the localization of the epileptogenic area during the periictal p eriod. Methods: A periictal DWI study was performed on a 35-year-old patient durin g focal status epilepticus with repetitive focal motor seizures originating from a lesion in the right frontal lobe. DWI results were analyzed visuall y and by calculating apparent diffusion coefficient (ADC) maps. Results: Om DWI, a single area of signal increase (decrease in ADC) was fou nd in the region of focal electrocorticographic seizures that was mapped in traoperatively. Conclusions: Ictal/postictal DWI may be a useful technique for seizure loca lization in patients with lesional epilepsy.