Rapidly Progressive Cognitive Disturbances Due to Nonconvulsive Status Epilepticus Associated with a Cerebral Microbleed: Clinical Application of FDG-PET

Nakagami, Yukako; Sugihara, Genichi; Uemura, Kazunori; Jingami, Naoto; Takahashi, Ryōsuke; Murai, Toshiya

doi:10.3805/eands.7.23

Cited by 2 publications

(2 citation statements)

References 15 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Deposition of hemosiderin, gliosis, meningocerebral cicatrix, and down-regulation of GABAergic pathway in the ischemic lesion are associated with pathogenesis of epilepsy [13][14][15]. A previous case report suggests that cerebral microbleeds may cause epileptogenic focus [16]. Therefore, the data of our patient suggest a possible association between cerebral ischemic lesions due to protein S deficiency and development of focal epileptogenicity.…”

Section: Discussionmentioning

confidence: 68%

Focal Seizures and Borderline Personality Disorder Associated with Protein S Deficiency and Multiple White Matter Ischemic Lesions

Murai¹,

Park²,

Obata³

et al. 2018

Neuropsychiatry

View full text Add to dashboard Cite

Neurological symptoms of patients with protein S deficiency remain elusive. We report a female case with protein S deficiency who started having episodes of sudden nausea, white out of the whole visual field, loss of consciousness, and falling down with convulsion at the age of 18. She was co-morbid with borderline personality disorder and gender identity disorder, and was treated with psychotherapy. She was suffering from extreme emotional lability causing deterioration of interpersonal relationships and repeated episodes of a suicidal attempt. Long-term video EEG revealed that her seizures started with abrupt visual symptoms followed by fine convulsion of extremities. Interictal EEG showed intermittent rhythmic slow waves and repetitive epileptiform discharges at bilateral parietal and occipital areas, and these activities became more frequent during ictal state. Brain MRI showed multiple spotty T2 and FLAIR high intensity lesions in deep white matter and subcortical areas disproportionate to her age. In blood test, the quantity of protein S was decreased to 53% (normal range; 65%-135%). The data of this patient suggest relationship among focal seizures, psychological complications, coagulation disorders, and brain ischemic lesion, which should be further investigated.

show abstract

Section: Discussionmentioning

confidence: 68%

Focal Seizures and Borderline Personality Disorder Associated with Protein S Deficiency and Multiple White Matter Ischemic Lesions

Murai¹,

Park²,

Obata³

et al. 2018

Neuropsychiatry

View full text Add to dashboard Cite

show abstract

“…Additionally, the exact time of admission, and CT and MRI acquisition were also recorded. Exclusion criteria included any diagnoses of comorbidities capable of causing WM TMBs [e.g., fat embolism, chronic hypertension, cerebral amyloid angiopathy, cavernous malformations, epilepsy, Alzheimer’s disease, dementia or migraine, brain tumor, or cerebral metastasis ( Susman et al, 2002 ; Nakata-Kudo et al, 2006 ; Brain Trauma Foundation et al, 2007 ; Haacke et al, 2007 ; Oh et al, 2008 ; Ayaz et al, 2010 ; Beauchamp et al, 2013 ; Kim and Lee, 2013 ; Nakagami et al, 2014 ; Shams et al, 2015 ; Yamauchi et al, 2016 ; Trifan et al, 2017 )] based on patient medical records. Grubbs’ test was applied to exclude patients with outlier TMB numbers.…”

Section: Methodsmentioning

confidence: 99%

Cerebral Microbleeds May Be Less Detectable by Susceptibility Weighted Imaging MRI From 24 to 72 Hours After Traumatic Brain Injury

et al. 2021

View full text Add to dashboard Cite

Purpose: A former rodent study showed that cerebral traumatic microbleeds (TMBs) may temporarily become invisible shortly after injury when detected by susceptibility weighted imaging (SWI). The present study aims to validate this phenomenon in human SWI.Methods: In this retrospective study, 46 traumatic brain injury (TBI) patients in various forms of severity were included and willingly complied with our strict selection criteria. Clinical parameters potentially affecting TMB count, Rotterdam and Marshall CT score, Mayo Clinic Classification, contusion number, and total volume were registered. The precise time between trauma and MRI [5 h 19 min to 141 h 54 min, including SWI and fluid-attenuated inversion recovery (FLAIR)] was individually recorded; TMB and FLAIR lesion counts were assessed. Four groups were created based on elapsed time between the trauma and MRI: 0–24, 24–48, 48–72, and >72 h. Kruskal–Wallis, ANOVA, Chi-square, and Fisher’s exact tests were used to reveal differences among the groups within clinical and imaging parameters; statistical power was calculated retrospectively for each comparison.Results: The Kruskal–Wallis ANOVA with Conover post hoc analysis showed significant (p = 0.01; 1−β > 0.9) median TMB number differences in the subacute period: 0–24 h = 4.00 (n = 11); 24–48 h = 1 (n = 14); 48–72 h = 1 (n = 11); and 72 h ≤ 7.5 (n = 10). Neither clinical parameters nor FLAIR lesions depicted significant differences among the groups.Conclusion: Our results demonstrate that TMBs on SWI MRI may temporarily become less detectable at 24–72 h following TBI.

show abstract

Rapidly Progressive Cognitive Disturbances Due to Nonconvulsive Status Epilepticus Associated with a Cerebral Microbleed: Clinical Application of FDG-PET

Cited by 2 publications

References 15 publications

Focal Seizures and Borderline Personality Disorder Associated with Protein S Deficiency and Multiple White Matter Ischemic Lesions

Focal Seizures and Borderline Personality Disorder Associated with Protein S Deficiency and Multiple White Matter Ischemic Lesions

Cerebral Microbleeds May Be Less Detectable by Susceptibility Weighted Imaging MRI From 24 to 72 Hours After Traumatic Brain Injury

Contact Info

Product

Resources

About