{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:59:48Z","timestamp":1781099988772,"version":"3.54.1"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003554","name":"Lundbeck Foundation","doi-asserted-by":"publisher","award":["R434\u20102023\u2010342"],"award-info":[{"award-number":["R434\u20102023\u2010342"]}],"id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Abnormalities on peri\u2010ictal diffusion\u2010weighted magnetic resonance imaging (DWI\u2010PMAs) are well\u2010established for patients with status epilepticus (SE), but knowledge on patterns of DWI\u2010PMAs and their prognostic impact is sparse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and individual participant data meta\u2010analysis included observational studies reporting adult patients with first\u2010time non\u2010anoxic SE with DWI\u2010PMAs. Authors reporting \u2265\u200910 patients were invited to share standardized individual participant data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 161 studies reporting on 531 individual patients (average age 52\u2009years) who could be classified into one of six different DWI\u2010PMA patterns. Of all reported DWI\u2010PMAs, 94.3% involved either cortex or hippocampus. Comparing DWI\u2010PMA patterns, pure hippocampal DWI\u2010PMAs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954, 10.2%) were associated with younger age, known epilepsy, and low mortality. Additional thalamic involvement (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009132, 26.1%) was linked to temporal DWI\u2010PMAs and was an independent predictor of poor functional outcome. Independent of the patterns, bilateral DWI\u2010PMAs and involvement of more than four cortical lobes were associated with worse outcome. Cerebellar involvement (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936, 6.8%) was associated with non\u2010temporal lobe DWI\u2010PMAs, coma, and independently associated with poor functional outcome. Lateralization of DWI\u2010PMAs and epileptic discharges showed substantial agreement (Cohen's kappa 0.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Lateralized or generalized period discharges were associated with thalamic involvement (54.2%) and were less frequent in patients with pure cortical (33.0%) or hippocampal DWI\u2010PMAs (21.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>DWI\u2010PMA due to SE originates from the cortex and\/or hippocampus depending on age and etiology. Additional involvement of the thalamus and cerebellum is associated with worse outcomes, as are more widespread DWI\u2010PMA. Lateralized or generalized periodic discharges are associated with thalamic involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70295","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T11:06:37Z","timestamp":1767006397000},"page":"1118-1128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of Postictal Abnormalities in Relation to Status Epilepticus in Adults"],"prefix":"10.1002","volume":"13","author":[{"given":"Andrea Enerstad","family":"Bolle","sequence":"first","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Sarria\u2010Estrada","sequence":"additional","affiliation":[{"name":"Department of Radiology, Neuroradiology Section 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