PMC5066582_01
MRI and DWI sequence (axial cuts) revealing gyriform pattern of diffusion restriction in (a) basal ganglia (caudate and putamen) and bilateral thalami, (b) caudate and along the cortex, and (c) bilateral medical cerebral hemispheres.
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Magnetic resonance imaging (MRI) of the brain with and without gadolinium contrast was obtained at the outside hospital prior to transfer and was notable for prominent diffusion restriction along the bilateral caudate, putamen, and thalami, as well as gyriform cortical restricted diffusion in the bilateral medial cerebral hemispheres (Figure 1).
Continuous EEG monitoring, with noted background activity consisting predominantly of 4-6 Hz activity, with initial waxing and waning periods of relative suppression for 1-3 s (not shown here) when the recording was initiated. There was no clear evidence for an occipital dominant rhythm, and definite delineation between sleep and wakefulness was not possible. There was no focal slowing, no interictal discharges, and no electrographic seizures identified.
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Continuous electroencephalogram (EEG) monitoring was obtained and demonstrated diffuse slowing, without evidence of seizure or periodic discharges (Figure 2).