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Isolated involvement of external capsules and claustrum in status epilepticus

Acometimento isolado da cápsula externa e claustro no status epilepticus

A 16-year-old previously-healthy girl started with one episode of fever and loss of consciousness a month earlier. After 15 days, she complained of a short-term memory impairment and six days later presented with status epilepticus. Cerebrospinal fluid, including PCR for herpes virus, was normal. Brain MRI revealed hyperintensities lesions in bilateral external capsules and claustrum, which disappeared four months later (Figure). The occurrence of external capsule and claustrum lesions secondary to status epilepticus has been described in few cases11. Steriade C, Tabg-Wai D.F, Krings T, Wennberg. Claustrum hyperintensities: A potencial clue to autoimmune epilepsy. Epilepsia Open 2017 Aug;2(4):476-80. https://doi.org/10.1002/epi4.12077
https://doi.org/10.1002/epi4.12077...
,22. Hwang K.J, Park K, Yoon S.S, Ahn T. Unusual lesion in the bilateral external capsule following status epilepticus: a case report. J Epilepsy Res. 2014 Dec;4(2):88-90. https://doi.org/10.14581/jer.14019
https://doi.org/10.14581/jer.14019...
. Transient cognitive and behavioral disturbances have been reported, and claustrum lesions may also be a clue for autoimmune epilepsy11. Steriade C, Tabg-Wai D.F, Krings T, Wennberg. Claustrum hyperintensities: A potencial clue to autoimmune epilepsy. Epilepsia Open 2017 Aug;2(4):476-80. https://doi.org/10.1002/epi4.12077
https://doi.org/10.1002/epi4.12077...
.

Figure
Axial (A/C) and coronal (B/D) T2-weighted and FLAIR MRI sequences – hyperintensities in bilateral external capsules and claustrum. Diffusion-weighted MRI images were unremarkable. Axial and coronal T2-weighted (E/F) MRI sequence showed no abnormalities at the four-month follow up.

References

  • 1
    Steriade C, Tabg-Wai D.F, Krings T, Wennberg. Claustrum hyperintensities: A potencial clue to autoimmune epilepsy. Epilepsia Open 2017 Aug;2(4):476-80. https://doi.org/10.1002/epi4.12077
    » https://doi.org/10.1002/epi4.12077
  • 2
    Hwang K.J, Park K, Yoon S.S, Ahn T. Unusual lesion in the bilateral external capsule following status epilepticus: a case report. J Epilepsy Res. 2014 Dec;4(2):88-90. https://doi.org/10.14581/jer.14019
    » https://doi.org/10.14581/jer.14019

Publication Dates

  • Publication in this collection
    00 00 2019
  • Date of issue
    May 2019

History

  • Received
    09 Oct 2018
  • Reviewed
    01 Jan 2019
  • Accepted
    01 Feb 2019
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