Arterial spin labeling hyperperfusion in seizures associated with non-ketotic hyperglycaemia: is it merely a post-ictal phenomenon?

• DOI: 10.1007/s10072-020-04815-6
• Publication Date: 2020-10-12T20:02:35Z
• Authors: Sabarish Sekar; Selvadasan Vinaya...; Bejoy Thomas; Chandrasekharan K...
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Seizures; Cerebrovascular Circulation; Hyperglycemia; Humans; Spin Labels; Arteries; Middle Aged; Magnetic Resonance Imaging; 3. Good health

A 53-year-old chronic uncontrolled diabetic patient presented with one episode of generalized seizures followed by drowsiness and post-ictal confusion. MR imaging at admission revealed left temporal subcortical T2/FLAIR hypointensities with overlying cortical T2/FLAIR hyperintensities and increased perfusion on arterial spin labeling (ASL). Follow-up imaging at 4- and 8-week interval revealed persistent ASL hyperperfusion with significant resolution of conventional MR imaging findings. Delayed persistent ASL hyperperfusion suggests that hyperglycemia-induced increased blood-brain barrier permeability rather than a mere post-ictal phenomenon in non-ketotic hyperglycemia (NKH) and may result in long-term cognitive disturbances.