Postictal or pathology? - MRI of epilepsy

#MRI is used to identify structural lesions that cause #epilepsy however #seizures themselves can cause changes on MRI. This lecture discusses these and how to distinguish these post ictal changes from limbic encephalitis.
#Postictal changes refer to transient alterations in brain imaging following a seizure. They are seen immediately after a (typically severe) seizure and may persist for hours to days resolving spontaneously without specific treatment. They are characterised by #hyperintense signal changes on T2W and FLAIR in the affected #brain regions. However, these changes can be difficult to distinguish from inflammation and as the “affected brain regions” often include the #temporal lobe the most important differential is limbic encephalitis.
Limbic encephalitis is an inflammatory disorder affecting the #limbic system of the brain, often #autoimmune or #paraneoplastic in nature. In some countries feline limbic encephalitis is called feline complex partial cluster seizure with orofacial involvement (#FEPSO) or Feline hippocampal and piriform lobe necrosis (#FHN). Limbic encephalitis will cause seizures whereas postictal changes are the consequence of seizures. However, like postictal changes, MRI of limbic encephalitis is characterised by hyperintense signal changes on T2-weighted and FLAIR sequences in the limbic structures, including the hippocampus, amygdala, and adjacent medial temporal lobes. In this lecture I guide you through features that help distinguish the limbic encephalitis, postictal changes and #neoplasia and discuss other changes that may occur following seizures.
00:00 Introduction
00:47 lesions causing or caused by seizures
03:48 MRI Feline Limbic encephalitis acute disease
05:22 MRI Feline limbic encephalitis after recovery acute disease
06:21 Limbic encephalitis example 2
09:35 Distinguishing limbic encephalitis from postictal changes and neoplasia
13:01 Brain atrophy following status epilepticus.

#MRI #Epilepsy #PostictalChanges #LimbicEncephalitis #BrainImaging #Neurology #Seizures #MedicalLecture #T2W #FLAIR #Neuroinflammation #StructuralLesions #TemporalLobe #Hippocampus #Amygdala #NeuroRadiology #AutoimmuneDisorders #Paraneoplastic #BrainHealth #MedicalEducation #ClinicalRadiology #veterinary #brain_on_fire #feline_complex_partial_cluster_seizure_with_orofacial_involvement #FEPSO #Feline_hippocampal_piriform_lobe_necrosis #FHN #feline #caninie