Reversible focal radiological changes due to non-convulsive status epilepticus of the right parietooccipital lobe

We describe a 62-year-old woman suffering from visual hallucination due to focal status epilepticus investigated by means of Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA), Electroencephalography (EEG), and 99m Technetium ethylcysteinate dimer Single Photon Emission Computed Tomography (Tc-99m ECD SPECT). EEG showed spikes in the right parietooccipital area. MRI demonstrated gyral swelling and signal hyperintensity in the right parietooccipital cortex with effacement of adjacent cortical sulci on T2- weighted and Fluid Attenuation Inversion Recovery (FLAIR) images. MRA indicated localized dilation of the right posterior cerebral artery (PCA) and parietal branch of the right middle cerebral artery (MCA), corresponding to the epileptic area shown on EEG. Hyperperfusion in the right parietooccipital lobe was observed by Tc-99m ECD SPECT. All these findings completely resolved on the follow-up studies 2 months later. We present the case showing the transient radiological alterations on MRA corresponding to the epileptic area.