Magnetic resonance imaging (MRI) is recommended for patients with epileptic seizures to rule out an underlying focal lesion. However, the radiological characteristics of epilepsy are not well elucidated. Transient periictal MRI abnormality (TPMA) refers to reversible MRI signal changes observed in epileptic patients. A 32-year-old man presented with a 2-week history of epileptic seizures, which initially manifested as focal aware seizures and progressed to a generalized tonic-clonic seizure on the third day. Electroencephalography showed sharp waves, sharp and slow wave complexes, and irregular δ waves over bilateral temporal lobes. After admission, brain MRI showed abnormal signals in the bilateral frontoparietal lobes. He was administered oral oxcarbazepine (75  mg twice daily). During follow-up he was seizure-free; the abnormal MRI signals persisted at 2 weeks, but were completely resolved at 4 months. The possibility of TPMA should be considered in patients with epileptic disorders, and differentiated from a potential epileptogenic lesion.

译文

对于癫痫发作的患者,建议使用磁共振成像 (MRI) 来排除潜在的局灶性病变。然而,癫痫的放射学特征尚未得到很好的阐明。短暂性发作期MRI异常 (TPMA) 是指在癫痫患者中观察到的可逆MRI信号变化。一名32岁的男子有2周的癫痫发作史,最初表现为局灶性癫痫发作,并在第三天发展为全身性强直阵挛发作。脑电图在双侧颞叶上显示尖波,尖波和慢波复合体以及不规则的 δ 波。入院后,脑部MRI显示双侧额顶叶异常信号。患者口服奥卡西平 (75   mg,每日2次)。在随访期间,他没有癫痫发作; 异常MRI信号在2周时持续存在,但在4个月时完全消失。癫痫疾病患者应考虑TPMA的可能性,并与潜在的致痫性病变区分开。

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