CROSSED CEREBELLAR DIASCHISIS IN A CHILD WITH STATUS EPILEPTICUS: AN UNUSUAL PRESENTATION
AbstractCrossed Cerebellar Diaschisis (CCD) describes a depression of oxidative metabolism and blood flow in the cerebellum secondary to a supratentorial lesion in the contralateral cerebral hemisphere. The pathophysiology is not clear but appears to be caused by abnormal neuronal connection of the primary to the remote site. The diagnosis is usually done using positron emission tomography (PET) and single-photon emission CT (SPECT) scans. Almost all the reported cases of CCD are caused by acute ischemic stroke in adults. Hence, CCD secondary to status epilepticus, extremely rare and there is limited literature available on it. This is important because it’s findings can easily be confused with acute ischemic stroke and similar concurrent diseases. Correct diagnosis can also help localize the cause of the seizures and significantly influence surgical decisions. We present a case of CCD in a child with status epilepticus using MRI of the brain with DWI.
Han S, Wang X, Xu K, Hu C. Crossed Cerebellar Diaschisis: Three Case Reports Imaging Using a Tri-Modality PET/CT-MR System. Medicine (Baltimore) 2016;95(2):e2526.
Zaidi SA, Haq MAu, Bindman D, Mathur S. Crossed cerebellar diaschisis: a radiological finding in status epilepticus not to miss. BMJ Case Rep 2013;2013:bcr2013200478.
Katramados AM, Burdette D, Patel SC, Schultz LR, Gaddam S, Mitsias PD. Periictal diffusion abnormalities of the thalamus in partial status epilepticus. Epilepsia 2009;50(2):265–75.
Sin DS, Kim MH, Park SA, Joo MC, Kim MS. Crossed Cerebellar Diaschisis: Risk Factors and Correlation to Functional Recovery in Intracerebral Hemorrhage. Ann Rehabil Med 2018;42(1):8–17.
Oster J, Doherty C, Grant PE, Simon M, Cole AJ. Diffusion-weighted imaging abnormalities in the splenium after seizures. Epilepsia 2003;44(6):852–4.
Chakravarty A. MR evaluation of crossed and uncrossed cerebral-cerebellar diaschisis. Acta Neurol Scand 2003;108(1):60–5.
Lansberg MG, O'Brien MW, Norbash AM, Moseley ME, Morrell M, Albers GW. MRI abnormalities associated with partial status epilepticus. Neurology 1999;52(5):1021–7.
Doherty CP, Cole AJ, Grant PE, Fischman A, Dooling E, Hoch DB, et al. Multimodal longitudinal imaging of focal status epilepticus. Can J Neurol Sci 2004;31(2):276–81.
Grant PE, He J, Halpern EF, Wu O, Schaefer PW, Schwamm LH, et al. Frequency and clinical context of decreased apparent diffusion coefficient reversal in the human brain. Radiology 2001;221(1):43–50.
Kamalian S, Lev MH. Stroke Imaging. Radiol Clin N Am 2019;57(4):717–32.
Cole AJ. Status epilepticus and periictal imaging. Epilepsia. 2004;45(Suppl 4):72–7.