Abstract
Medial temporal lobe epilepsy is commonly associated with hippocampal atrophy on MRI
and hippocampal sclerosis on histopathological examination of surgically-resected
specimens. Likewise, it is well-established that prolonged seizures and status epilepticus
can lead to hippocampal edema as noted on MRI.
In this paper, the authors present an unusual patient with prolonged refractory status
epilepticus, due to limbic encephalitis associated with anti-GAD antibody, who underwent
palliative epilepsy surgery. Bilateral hippocampal edema was noted on preoperative
MRI. Histologic evaluation confirmed presence of acute necrosis and neuronal loss
in the left hippocampal formation. Follow-up MRI several months after surgery demonstrated
severe atrophy of the contralateral right hippocampus.
This is the first clear histopathological evidence that hippocampal atrophy following
status epilepticus is the result of acute neuronal necrosis and cell loss.
Keywords
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Article info
Publication history
Published online: August 30, 2013
Accepted:
August 11,
2013
Received in revised form:
July 19,
2013
Received:
March 7,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
