Clinical Analysis Of Unilateral Hemisphere Damage After Status Epilepticus

Background and Objective: Status epilepticus is the most severe manifestation ofepilepsy and an acute and critical condition in neurologic practice. The brain damagescaused by status epilepticus can result in the brain dysfunction being either transient,reversible and focal or widespread and permanent, even the survival in vegetative stateor sudden death. There are a few reports on status epilepticus causing the unilateralhemisphere damage, and the mechanism is unclear. In this paper, the unilateralhemisphere damage after status epilepticus in three patients were reported and theclinical manifestations, imaging features and prognosis were analyzed, in order toenhance understanding status epilepticus induced brain damage and guide clinicalpractice afterward.Methods: The medical records of three patients with unilateral hemisphere damageafter status epilepticus admitted in Department of Neurology, the General Hospital ofShenyang Military Command, from January2007to October2012, were reviewed. Theclinical data, EEG, neuroimaging findings and follow-up data of them wereretrospectively analyzed, together with the literature to explore the Etiology andpathogenesis, imaging characteristics, and prognosis.Results: Three patients have the past history of epilepsy. They manifested thegeneralized tonic-clonic seizures one to several times with one to two hours each time.They showed hemiplegia after the termination of the seizure, and one also hadhemidysesthesia. The neuroimagings of them showed the signal abnormalities ofunilateral hemispheres including frontal, pariental, temperal ocipital lobes, as well ashippocampus or callosal splenium. The MRA showed no intracranial vascularabnormalities in all patients. For a period of one month follow-up, three patients wereleft a different degrees of hemiparalysis, the hemiplegia unchanged in two cases andindependent walking in one.Conclusion: Epilepsy induced unilateral hemisphere damage often resulted from the generalized tonic-clonic status epilepticus. The neuroimaging usually manifestedunilateral hemisphere cortex and subcortical white matter abnormalities. The severeparalysis of limbs often left. Therefore, the timely termination of status epilepticusseizures is of importance in reducing epileptic brain damage and improving the lifequality.