The spectrum of peri-ictal MRI changes; four illustrative cases

These acute ictal imaging changes give clinicians an important in-vivo look at the dynamic neuronal metabolic environment in the peri-ictal period. Areas that appear most susceptible include the mesial temporal structures and corpus callosum. Close imaging follow up to document resolution or evolution of long lasting sequelae is vital. There is no clear consensus as to why some patients develop ictal related imaging changes and others do not. Seizure length and time interval from ictus to scan appear to play a role but larger prospective studies are needed to confirm this.