Status epilepticus and cortical laminar necrosis

Discussion:

The mechanisms that induce epileptic activity and make it durable, leading to status epilepticus (SE), are poorly known. Many mechanisms can lead to permanent brain damage as a result of SE.

It is known that status epilepticus increases the cerebral metabolic demand for glucose and oxygen and, as a result, a compensatory increase in cerebral blood flow occurs. When this blood inflow is not sufficient, adenosine triphosphate depletion and lactate accumulation occur and leads to hypermetabolic neural necrosis. 

Generally, all the radiological cortical signal changes observed with focal SE seem to be reversible. However, like in this case, a group of patients may display permanent brain damage after SE, with radiological changes suggestive of cortical laminar necrosis (CLN)

This patient had focal SE involving the posterior quadrant of the hemisphere, as previous cases reported in the literature 1.

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