LAUSR

A 52-year-old woman with a past history of a tumefactive demyelinating lesion five years ago with left hemiparesis presented with a 30-day history of uninterrupted clonic movements involving her left face and upper limb, compatible with epilepsia partialis continua. An MRI showed right hemispheric cortical swelling (Figure 1). She received phenytoin, valproate and phenobarbital with control of the epilepsia partialis continua and resolution of the MRI abnormalities (Figure 2). The reason for cerebral edema in status epilepticus is unknown1, but restricted cortical diffusion is consistent with cytotoxic edema by cellular energy failure2,3. It can be triggered by an imbalance between the energy supply and demand in neurons and it remains unclear why only certain patients have these abnormalities1,3,4.