A total of 49 cases were analysed. Abnormalities appeared as early as during the ictus, and had a median resolution time of 96.5 days. SRMA were commonly seen on T2-weighted sequences (86%), and abnormalities were most frequently observed in the cortex (35%), hippocampi (29%), and claustrum (18%). In both ictal and interictal EEG, unilateral findings were associated with unilateral SRMA, ipsilateral to the EEG finding.  Common locations of signal change included the cortex, hippocampus and claustrum, with long-term sequelae of cortical atrophy, hippocampal sclerosis and cortical laminar necrosis being observed even after resolution of SRMA.

From our investigation of the current literature regarding SRMA in SE patients, we found several stereotypic patterns of signal alterations.  Recognition of these patterns will help the clinician in differentiating SRMA from underlying lesions.