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Hyperperfusion can identify epileptic stroke mimics
  1. Stoyan Popkirov,
  2. Wenke Grönheit
  1. Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany
  1. Correspondence to Dr Stoyan Popkirov, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum 44801, Germany; popkirov{at}gmail.com

https://doi.org/10.1136/practneurol-2019-002255

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    Introduction

    CT perfusion is useful in acute ischaemic stroke to image cerebral tissue at risk (penumbra).1 However, perfusion changes are also common in people with ongoing epileptic seizures or postictal deficits (eg, Todd’s paresis).2 3 Although reduced or unchanged regional brain perfusion during ictal and postictal states is of little diagnostic help, hyperperfusion can suggest epileptic pathology. We report an illustrative case.

    Case history

    An elderly man was admitted with a suspected stroke. His wife had noticed subtle signs of confusion in him while shopping. When they …

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    Footnotes

    • Contributors Both authors contributed equally to this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed by Hugh Markus, Cambridge, UK.

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