{
  "abstract": "Background Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare condition that occurs after brain irradiation. Typically, the condition presents with a migraine headache followed by stroke-like symptomatology. Patients with SMART syndrome have been reported to have seizures. However, patients presenting with status epilepticus are rare.Case Here we present the case of a 62-year-old gentleman who initially presented with stroke-like symptoms about 10 years after chemoradiotherapy for a left parietal glioblastoma multiforme. He presented with fluctuating right sided weakness, dysarthria, dysphasia, and right sided hemianopia. His initial stroke imaging series demonstrated increased cerebral blood flow, which was suggestive of seizures. This was confirmed by an electroencephalogram (EEG), which demonstrated status epilepticus with a focus over the left parietal region. A magnetic resonance image (MRI) of his brain demonstrated gyral swelling and diffusion restriction in the left parietal region. The patient required five antiseizure medications and intravenous methylprednisone to stop his seizures. With improvement in his mental state, he was transferred to the rehabilitation ward where he experienced ongoing cognitive deficits. He was reviewed about 6 months later with apparent complete recovery and his anti-seizure medications were rationalised and he was steroid free.Our patient presented with status epilepticus in the context of SMART syndrome. While rare, our patient had the MRI and CT perfusion changes that have been demonstrated in previously reported patient. Consistent with previous cases, recovery from SMART often requires treatment with steroids and anti-epilepticus. Full recovery may take weeks to months.",
  "authors": [
    {
      "affiliations": [
        "Princess Alexandra Hospital, Woolloongabba, QLD, Australia"
      ],
      "name": "Joshua Tam"
    },
    {
      "affiliations": [
        "Neurology, Townsville University Hospital, Townsville, NSW, Australia"
      ],
      "name": "Trung Tran"
    },
    {
      "affiliations": [
        "Neurology, Townsville University Hospital, Townsville, NSW, Australia"
      ],
      "name": "Linda Tjoa"
    }
  ],
  "title": "3675 SMART syndrome: seizing the spotlight with status epilepticus",
  "uid": "3a54bdd5-388e-58e7-a6dc-01a4cdb564bb"
}