Abstract Details

Title Seizure-induced Reversible MRI Abnormalities in Single Seizures: Current Knowledge and Future Directions

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 142

Objective To identify the characteristic features of seizure-induced reversible MRI abnormalities (SRMA) in patients presenting with a seizure.

Background SRMA are a recognized, but incompletely understood radiological phenomenon. Differentiating SRMA from epileptogenic pathologies, poses a clinical challenge.

Design/Methods A systematic search of Medline, PubMed and Embase was performed. All English publications of SRMA in patients with single unprovoked seizures, that demonstrated complete resolution were included. Our study was conducted according to the Preferred Items Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results A total of 27 cases met our eligibility criteria. SRMA were noted to appear as early as six hours post-ictus and resolve as soon as five days later, with a median resolution time of 39 days. Abnormalities were most frequently observed on T2-weighted sequences (89%) and were most commonly subcortical (41%) or hippocampal (26%) in location. Generalised seizures generally exhibited bilateral SRMA (71%), with focal seizures demonstrating unilateral abnormalities (80%).

Conclusions SRMA manifested heterogeneously, most commonly seen on T2-weighted sequences. They presented within hours of seizure onset and resolve in days to weeks. Abnormalities were most frequently observed in the hippocampi and subcortical layers. Our study highlights several shortcomings in the literature and sheds light on future directions of research to improve our understanding of this clinical dilemma.

Authors/Disclosures
Frederick P. Mariajoseph PRESENTER	Mr. Mariajoseph has nothing to disclose.
Subramanian Muthusamy, MBBS (MMC)	Dr. Muthusamy has nothing to disclose.
	No disclosure on file
Udaya K. Seneviratne, MD (Monash Medical Centre)	Dr. Seneviratne has nothing to disclose.

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