PMC7303554_01
A and B. Rhythmic delta-theta activity on left centro-parieto-temporal region. C. Non-rhythmic delta-theta activity in the left temporo-parietal region immediately after treatment with 2 mg of clonazepam and 1000 mg of levetiracetam. D. Intermittent non-rhythmic delta-theta slowing in the left temporo-parietal region the day after status epilepticus.
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On EEG, continuous rhythmic theta-delta activity with a fluctuating frequency between 1.5 and 5 Hz in the left centro-parieto-temporal area was demonstrated (Fig. 1A-B). The ictal rhythmic theta-delta activity on EEG resolved promptly after IV administration of 2 mg of clonazepam and 1000 mg of levetiracetam and transformed into low amplitude intermittent non-rhythmic delta-theta activity in the left temporo-parietal area and a sleep pattern (Fig. 1C). The next morning, EEG showed intermittent non-rhythmic delta-theta activity in the left temporo-parietal area (Fig. 1D).
Imaging features of a patient with a status epilepticus presented as right arm apraxia. Post-hemorrhagic parenchymal defect affecting left temporo-parietal area (A-F) and multiple micro bleeds due to suspected cerebral amyloid angiopathy (D). Absent diffusion restriction on DWI (E).. A-E MRI: A. Coronal FLAIR (fluid attenuated inversion recovery); B. Sagittal T1-weighted image; C. Axial T1-weighted image; D. Axial SWI (susceptibility weighted image); E. Axial DWI (diffusion weighted image); F. CT scan, axial view.
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An MRI showed an old parenchymal defect in the left temporo-parietal area with a residual hemosiderin rim on a susceptibility weighted imaging (SWI) and no diffusion restriction in a diffusion weighted image (DWI) (Fig. 2).