Seizure related restricted diffusion

Discussion:

The patient had been a heavy alcohol drinker (4-6L wine a day) and recently decided to quit cold turkey, prior to admission. 

This patient went on to have a lumbar puncture which was bland with negative HSV PCR. 

Thalamic as well as hippocampal high DWI signal is well described in the peri-ictal period in the setting of prolonged seizures. 

Limbic (paraneoplastic) encephalitis is also a consideration on imaging, however it is at odds with the acute presentation. 

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