EC Neurology

Crossed cerebellar diaschisis (CCD) is a rare phenomenon characterised by a reduction in hemispheric cerebellar blood flow and metabolism secondary to a supratentorial lesion. Although commonly identified following an ischaemic stroke, CCD can also occur during status epilepticus. We present the case of a 32-year-old woman with a history of epilepsy and chronic headaches who experienced a seizure episode with initial symptoms mimicking a stroke. Radiological findings revealed extensive cytotoxic oedema in the left hemisphere, accompanied by a smaller lesion in the right cerebellar hemisphere, indicating the rare occurrence of CCD. A diagnosis of status epilepticus was subsequently confirmed. Despite initial deterioration, the patient’s condition improved after intensive treatment over several weeks. Recognising seizure activity in patients presenting with stroke-like changes on non-contrast CT scans is crucial, especially in the absence of arterial occlusion on angiography and in cases with asymmetric arterial vasodilation. Status epilepticus can mimic stroke, posing a significant diagnostic challenge.

 Keywords: Diaschisis; Epilepsy; Convulsions; Cerebral Edema; Cerebellum

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