PMC6088478_01
Electroencephalogram findings: (filter, HFF-70 Hz, LFF-1 Hz). At the beginning of the study, no clear posterior dominant rhythms were seen. There were generalized continuous frontal predominant sharp transients of biphasic and triphasic morphology at 2.5-3 Hz. After administration of lorazepam 1 mg (right image), there was resolution of the sharp transients with better organized slow background-low amplitude 4-5 Hz showing variability. There was no immediate significant improvement in the mental status; however, the eyelid flutter resolved and patient grimaced more easily to jaw stimulation. Findings were suggestive of non-convulsive status epilepticus patterns that responded adequately to intravenous lorazepam.
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The EEG was repeated and showed non-convulsive status epilepticus which was controlled with one dose of 1 mg lorazepam followed by levetiracetam (see Figure 1).
MRI, 3D axial T1 post contrast: (a) pre-steroid, diffuse leptomeningeal enhancement (white arrows); (b) post-steroids. Resolution of meningeal enhancement.
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A magnetic resonance imaging (MRI) of the brain showed diffuse leptomeningeal enhancement (Figure 2(a)). MRI on day 8 showed resolution of the previous findings (Figure 2(b)), and EEG showed no further seizures.