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Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report
INTRODUCTION: Stroke mimics are a major diagnostic challenge during the initial evaluation of patients presenting with an acute focal neurological deficit. This case reviews a patient who presented to the emergency department (ED) with homonymous hemianopsia, a rare manifestation of focal status epi...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436493/ https://www.ncbi.nlm.nih.gov/pubmed/36049189 http://dx.doi.org/10.5811/cpcem.2022.1.55482 |
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author | Lawson, Jordan Triner, Wayne Kluge, Brady |
author_facet | Lawson, Jordan Triner, Wayne Kluge, Brady |
author_sort | Lawson, Jordan |
collection | PubMed |
description | INTRODUCTION: Stroke mimics are a major diagnostic challenge during the initial evaluation of patients presenting with an acute focal neurological deficit. This case reviews a patient who presented to the emergency department (ED) with homonymous hemianopsia, a rare manifestation of focal status epilepticus of the occipital lobe. Her initial brain computed axial tomographic perfusion scan and magnetic resonance imaging revealed novel findings associated with this diagnosis. CASE REPORT: A 70-year-old female presented to our ED with left visual field hemianopsia, dyskinesia, dysmetria, and facial droop. Her initial diagnosis was left posterior fossa circulation cerebrovascular accident. However, her neuroimaging indicated hypervascularity of the left occipital lobe without evidence of infarct or structural lesion. A cerebral angiogram excluded arteriovenous malformation. Subsequently, an electroencephalogram showed left occipital lobe status epilepticus. CONCLUSION: Hemianopsia is a rare presentation of focal status epilepticus mimicking stroke. Hypervascularity seen on advanced neuroimaging may have suggested this diagnosis on initial ED evaluation. |
format | Online Article Text |
id | pubmed-9436493 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-94364932022-09-02 Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report Lawson, Jordan Triner, Wayne Kluge, Brady Clin Pract Cases Emerg Med Case Report INTRODUCTION: Stroke mimics are a major diagnostic challenge during the initial evaluation of patients presenting with an acute focal neurological deficit. This case reviews a patient who presented to the emergency department (ED) with homonymous hemianopsia, a rare manifestation of focal status epilepticus of the occipital lobe. Her initial brain computed axial tomographic perfusion scan and magnetic resonance imaging revealed novel findings associated with this diagnosis. CASE REPORT: A 70-year-old female presented to our ED with left visual field hemianopsia, dyskinesia, dysmetria, and facial droop. Her initial diagnosis was left posterior fossa circulation cerebrovascular accident. However, her neuroimaging indicated hypervascularity of the left occipital lobe without evidence of infarct or structural lesion. A cerebral angiogram excluded arteriovenous malformation. Subsequently, an electroencephalogram showed left occipital lobe status epilepticus. CONCLUSION: Hemianopsia is a rare presentation of focal status epilepticus mimicking stroke. Hypervascularity seen on advanced neuroimaging may have suggested this diagnosis on initial ED evaluation. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2022-07-26 /pmc/articles/PMC9436493/ /pubmed/36049189 http://dx.doi.org/10.5811/cpcem.2022.1.55482 Text en © 2022 Lawson https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Case Report Lawson, Jordan Triner, Wayne Kluge, Brady Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title | Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title_full | Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title_fullStr | Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title_full_unstemmed | Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title_short | Occipital Lobe Status Epilepticus, A Stroke Mimic with Novel Imaging Findings: A Case Report |
title_sort | occipital lobe status epilepticus, a stroke mimic with novel imaging findings: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436493/ https://www.ncbi.nlm.nih.gov/pubmed/36049189 http://dx.doi.org/10.5811/cpcem.2022.1.55482 |
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