Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

16 December 2019 : Case report  Japan

Arterial Spin Labeling Magnetic Resonance Imaging in the Assessment of Non-Convulsive Status Epilepticus in Alzheimer’s Disease: A Report of Two Cases

Challenging differential diagnosis

Tatsushi Mutoh1BDEFG*, Kaoru Eguchi2BDEF, Shuzo Yamamoto12BD, Nobuyuki Yasui2B, Yasuyuki Taki1DE

DOI: 10.12659/AJCR.919938

Am J Case Rep 2019; 20:1883-1887

Abstract

BACKGROUND: The diagnosis of early non-convulsant status epilepticus (NCSE) can be challenging and can overlap with other critical conditions. Two patients with Alzheimer’s disease are reported with clinically suspected NCSE presenting in the emergency setting who were diagnosed using arterial spin-labeling magnetic resonance imaging (ASL-MRI) sequences.

CASE REPORT: In Case 1, a 69-year-old woman with mild Alzheimer’s disease and diabetes presented with acute worsening of cognitive status and fluctuating level of consciousness. In Case 2, a 70-year-old man with mild cognitive impairment due to Alzheimer’s disease and hypertension presented with acute loss of consciousness and left hemiparesis, without evidence of hypoglycemia or a hypertensive crisis. In both cases, ASL-MRI perfusion images showed focal cerebral hyperperfusion in the posterior cingulate and parietal associative cortex, which involved neurodegenerative areas associated with epilepsy in early Alzheimer’s disease. In both cases, the patients developed generalized tonic-clonic epileptic seizures that lasted for 5 minutes or more, which indicated the emergence of status epilepticus that developed from the initial presentation of NCSE. In both cases, electroencephalogram (EEG) findings confirmed that the seizures were controlled by intravenous administration of antiepileptic drugs. Both patients discharged home from the hospital without recurrence of seizures, between 10–12 days after the onset of symptoms.

CONCLUSIONS: These two cases have demonstrated that ASL-MRI is feasible as an emergency diagnostic tool in clinically suspected NCSE in patients with Alzheimer’s disease.

Keywords: Dementia, Magnetic Resonance Imaging, Regional Blood Flow, Status epilepticus, Aged, Alzheimer Disease, Anticonvulsants, Diagnosis, Differential, Spin Labels

0 Comments

In Press

27 Jan 2023 : Case report  Spain

A 37-Year-Old Man with Familial Hereditary Hemorrhagic Telangiectasia and Pulmonary Arteriovenous Malformat...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938548  

26 Jan 2023 : Case report  Spain

A 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Sur...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938169  

26 Jan 2023 : Case report  USA

Optic Neuritis as a Consequence of Long-Term Medical Treatment Using Anastrozole: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.939026  

26 Jan 2023 : Case report  USA

A Rare Case of Ruptured Appendicitis Secondary to Metastatic Ovarian Cancer

Am J Case Rep In Press; DOI: 10.12659/AJCR.938982  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923