Nonconvulsive status epilepticus in patients with cancer:
imaging abnormalities
Hormigo A, Liberato B, Lis E, DeAngelis LM
Department of Neurology, Memorial Sloan-Kettering Cancer Center,
and Weill Medical College of Cornell University, New York, NY 10021, USA.
hormigoa@mskcc.org
Background. Convulsive status epilepticus may cause reversible
neuroimaging abnormalities.
These cortical changes have been reported rarely in association with
nonconvulsive status epilepticus.
Objective. To describe patients with cancer who had reversible
magnetic resonance (MR) imaging abnormalities from nonconvulsive status
epilepticus and whose altered mental status and MR imaging findings were
initially considered to result from a structural lesion related to their
underlying tumor.
Design. Retrospective study.
Setting.
Department of
Neurology at Memorial Sloan-Kettering Cancer Center, New York, NY.
Patients. Eight patients with a diagnosis of nonconvulsive status
epilepticus who underwent MR imaging.
Results.
Enhancing cortical
abnormalities were observed on MR images in 4 (50%) of 8 patients with cancer
who had impaired mental status and an electroencephalogram demonstrating seizure
activity.
Follow-up MR images showed neuroimaging improvement or resolution in all
patients.
Conclusions.
Cortical
enhancement on MR images in patients with cancer who have altered mental status
may be due to nonconvulsive status epilepticus and not recurrent or metastatic
tumor.
If electroencephalography is not immediately available at initial evaluation, a
trial of anticonvulsant therapy deserves consideration.
PMID: 15023812 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15023812
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