PMC9424760_01
Timeline of clinical development, therapy, and MRI-findings.
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F1
The clinical, laboratory, and imaging findings are summarized in Table 1 and are illustrated in Figure 1.
Electroencephalogram on day 8 after symptom onset showing a brief focal seizure. The seizure discharge begins with an evolving fast rhythm with onset in the left temporal leads and interspersed epileptic discharges. There is generalized background slowing following the seizure. Bipolar longitudinal montage, gain 70 muV/cm, base time 3 cm/s, high-pass filter. 53 Hz, low-pass filter 80 Hz, and notch filter 50 Hz.
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F2
Frequent brief electrographic seizures were also detected (Figure 2).
Neuroimaging findings. (A) cMRI on day 13: axial FLAIR sequence demonstrating edematous changes in hippocampus and parahippocampal gyrus predominantly on the left side. (B) cMRI on day 23: coronary FLAIR sequence demonstrating progression of edema on both sides, the hippocampus and parahippocampal gyrus, additional subcortical FLAIR hyperintensities subinsular on both sides. (C,D) demonstrate the claustra hyperintensities.
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F3
Additionally, FLAIR hyperintensive lesions in the bilateral subinsular regions were detected (Figure 3).