Neuroimaging features in subacute encephalopathy with seizures in alcoholics (SESA syndrome)

Abstract

PurposeTo describe the neuroimaging findings in subacute encephalopathy with seizures in alcoholics (SESA syndrome). MethodsWe reviewed all cases reported previously, as well as 4 patients diagnosed in our center. We included a total of 8 patients. All subjects had clinical and EEG findings compatible with SESA syndrome and at least one MRI study that did not show other underlying condition that could be responsible for the clinical presentation. ResultsInitial MRI studies revealed the following features: cortical–subcortical areas of increased T2/FLAIR signal and restricted diffusion (6 patients), hyperperfusion (3 patients), atrophy (5 patients), chronic microvascular ischemic changes (4 patients). Follow-up MRI was performed in half of the patients, all showing a resolution of the hyperintense lesions, but developing focal atrophic changes in 75%. ConclusionsSESA syndrome should be included among the alcohol-related encephalopathies. Its radiological features include transient cortical–subcortical T2-hyperintense areas with restricted diffusion (overlapping the typical findings in status epilepticus) observed in a patient with atrophy and chronic multifocal vascular lesions.