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Neurocritical Care
Published in: Neurocritical Care 1/2010

01-02-2010 | Practical Pearl

Crossed Cerebellar Diaschisis in Status Epilepticus

Authors: Edgar A. Samaniego, Erika Stuckert, Nancy Fischbein, Christine A. C. Wijman

Published in: Neurocritical Care | Issue 1/2010

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Abstract

Background

Crossed cerebellar diaschisis (CCD) has been reported on positron-emission tomography and single-photon emission computed tomography of stroke patients. Rarely it has been described with brain diffusion-weighted MRI (DWI) of status epilepticus (SE).

Methods

Case report.

Results

A 53-year-old woman was found unresponsive after cocaine use. A diagnostic electroencephalogram was consistent with ictal SE. A brain DWI showed reduced diffusion in the left temporo-parietal and occipital cortexes, the left thalamus and the right cerebellum. The DWI changes did not correspond to a vascular territory and were attributed to seizure activity and secondary CCD. A 2-week follow-up DWI showed interval near-complete resolution of the diffusion changes. CCD in SE may represent injury caused by excessive neuronal transmission from prolonged excitatory synaptic activity via the cortico-pontine-cerebellar pathway. Alternatively, it may be a result of interruption of the cortico-pontine-cerebellar pathway with loss of cortical inhibitory input.

Conclusion

This case documents CCD during SE, providing further evidence of contralateral cerebellar involvement with a supratentorial epileptiform focus.
Literature
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Metadata
Title
Crossed Cerebellar Diaschisis in Status Epilepticus
Authors
Edgar A. Samaniego
Erika Stuckert
Nancy Fischbein
Christine A. C. Wijman
Publication date
01-02-2010
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 1/2010
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-009-9312-y

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