Thalamic Hyperintensity on Diffusion-Weighted MRI in a Patient with Nonconvulsive Status Epilepticus

We present a 70-year-old woman with nonconvulsive status epilepticus (NCSE) with thalamic hyperintensity on diffusion-weighted MRI (DWI). She had no previous history of epilepsy. Her altered mentality was not normalized though we successfully controlled the ictal activity by standard treatment. Initial DWI showed diffuse hyperintensity in the right thalamus, which raised the possibility of seizure-related change. At the follow-up DWI, more localized high signal intensity lesion was present in the right pulvinar area. There was no apparent cause of her NCSE despite our extensive work-ups. The authors suggest that transient ischemia is a possible causative pathomechanism in this case.