Seizure - European Journal of Epilepsy Characteristics of seizure-induced signal changes on MRI in patients with first seizures  Si Eun Kim, Byung In Lee, Kyong Jin Shin, Sam Yeol Ha, JinSe Park, Kang Min Park, Hyung Chan Kim, Joonwon Lee, Soo-young Bae, Dongah Lee, Sung Eun Kim  Seizure - European Journal of Epilepsy  Volume 48, Pages 62-68 (May 2017) DOI: 10.1016/j.seizure.2017.04.005 Copyright © 2017 British Epilepsy Association Terms and Conditions

Fig. 1 A case of reversible SCM. Index diffusion MRI (figure A) showed high signal intensity (SI) on with low SI on ADC map in the anterior and medial cortex of the left frontal lobe of unusual vascular territory. And there were Flair signal changes in same lesion on DWI but no lesions on T1 weighted image (T1WI). 5 months later, previous lesion disappeared in follow up MRI (figure B). Seizure - European Journal of Epilepsy 2017 48, 62-68DOI: (10.1016/j.seizure.2017.04.005) Copyright © 2017 British Epilepsy Association Terms and Conditions

Fig. 2 Topography of SCM. Topography of SCM was as follows; 1) ipsilateral hippocampus, thalamus and cerebral cortex (figure A), 2) ipsilateral thalamus and cerebral cortex (figure B), 3) unilateral cortex (figure C), 4) bilateral hippocampus (figure D). Seizure - European Journal of Epilepsy 2017 48, 62-68DOI: (10.1016/j.seizure.2017.04.005) Copyright © 2017 British Epilepsy Association Terms and Conditions

Fig. 3 Illustrative case of topography of SCM involving the unilateral cortex and ipsilateral thalamus and its hyperperfusion state. DWI showed regional cytotoxic edema in the right frontotemporal lobe, right hippocampus, and right thalamus (figure A). And perfusion CT revealed cerebral hyperperfusion state (increased cerebral blood flow [CBF], cerebral blood volume [CBV] and decreased time to peak [TTP], mean transit time [MTT]) in the right middle cerebral artery (MCA) territory and right thalamus (figure B). Cerebral CT angiography demonstrated increased vascularity of right MCA compared to the left MCA. Considering posterior cerebral artery was not fetal type (asterisk), increased perfusion to thalamus was not associated to increased flow through the ICA (figure C). Seizure - European Journal of Epilepsy 2017 48, 62-68DOI: (10.1016/j.seizure.2017.04.005) Copyright © 2017 British Epilepsy Association Terms and Conditions