Abstract
Reversible bilateral lesions of the claustrum and external capsule in a 12-year-old girl suffering from a severe, transitory encephalopathy are reported. After a prodromal stage of feeling uncomfortable a sudden onset of status epilepticus occurred, followed by recurrent complex partial and myoclonic seizures for 3 weeks, with psychotic symptoms and temporary loss of vision, speech and hearing. After treatment with phenytoin the patient became free of seizures and recovered completely without neurological deficit. The initial cranial CTwas normal; however, cranial MRI 7 days later showed bilateral selective lesions of the claustrum and external capsule, which disappeared completely 5 weeks later. The aetiology of these lesions remains obscure; repeated cerebrospinal fluid and blood tests were negative for herpes simplex virus and other infectious agents. The clinical and radiological improvement were concomitant. This may indicate a functional disturbance of the claustrum grey matter, rather than lesions of the white matter of the external and extreme capsules.
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References
Tien RD, Felsberg GJ (1995) The hippocampus in status epilepticus: demonstration of signal intensity and morphologic changes with sequential fast spin-echo MR imaging. Radiology 194: 249–256
Yaffe K, Ferriero D, Barkovich AJ, Rowley H (1995) Reversible MRI abnormalities following seizures. Neurology 45: 104–108
Henry TR, Drury I, Brunberg JA, et al (1994) Focal cerebral magnetic resonance changes associated with partial status epilepticus. Epilepsia 35: 35–41
Kimura S, Nezu A, Osaka H, Saito K (1994) Symmetrical external capsule lesions in a patient with herpes simplex encephalitis. Neuropediatrics 25: 162–164
Sener RN (1993) The claustrum on MRI: normal anatomy, and the bright claustrum as a new sign in Wilson's disease. Pediatr Radiol 23: 594–596
Williams PL, Warwick R, Dyson M, Bannister LH (1989) Gray's anatomy, 37th edn. Churchill Livingstone, Edinburgh, p 1080
Tien R, Ashdown B, Lewis DV, Atkins MR, Burger PC (1991) Rasmussen's encephalitis: neuroimaging findings in four patients. AJR 158:1329–1332
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Sperner, J., Sander, B., Lau, S. et al. Severe transitory encephalopathy with reversible lesions of the claustrum. Pediatr Radiol 26, 769–771 (1996). https://doi.org/10.1007/BF01396197
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DOI: https://doi.org/10.1007/BF01396197