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The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis).

Matsubara T, Ayuzawa S, Aoki T, Fujiomto A, Osuka S, Matsumura A - Epilepsy Behav Case Rep (2013)

Bottom Line: We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst.Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus.Hippocampal sclerosis was histopathologically confirmed (dual pathology).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Tsukuba University Hospital, Japan.

ABSTRACT
Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst.

No MeSH data available.


Related in: MedlinePlus

MRI shows a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex (A, B; axial T2 weighted-imaging, C; sagittal T1-weighted imaging), but no atrophy or abnormal signal alteration is seen in the bilateral hippocampi (D, E; coronal T2-weighted imaging).
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f0005: MRI shows a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex (A, B; axial T2 weighted-imaging, C; sagittal T1-weighted imaging), but no atrophy or abnormal signal alteration is seen in the bilateral hippocampi (D, E; coronal T2-weighted imaging).

Mentions: Magnetic resonance imaging revealed a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex, no cortical dysgenesis, and, importantly, no atrophy or abnormal signal alteration in the bilateral hippocampi (Fig. 1). Long-term video-electroencephalography (EEG) monitoring revealed interictal epileptiform discharges in the left anterior temporal lesion (Fig. 2); however, no ictal onset could be localized. Interictal 99mTc-ethyl cysteinate dimer (99mTc-ECD) single-photon emission computed tomography (SPECT) revealed decreased cerebral blood flow in the mesial left temporal lobe. Ictal ECD SPECT was not performed because of technical limitations.


The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis).

Matsubara T, Ayuzawa S, Aoki T, Fujiomto A, Osuka S, Matsumura A - Epilepsy Behav Case Rep (2013)

MRI shows a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex (A, B; axial T2 weighted-imaging, C; sagittal T1-weighted imaging), but no atrophy or abnormal signal alteration is seen in the bilateral hippocampi (D, E; coronal T2-weighted imaging).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150633&req=5

f0005: MRI shows a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex (A, B; axial T2 weighted-imaging, C; sagittal T1-weighted imaging), but no atrophy or abnormal signal alteration is seen in the bilateral hippocampi (D, E; coronal T2-weighted imaging).
Mentions: Magnetic resonance imaging revealed a large porencephalic cyst in the left parietotemporal region with atrophic changes in the surrounding cortex, no cortical dysgenesis, and, importantly, no atrophy or abnormal signal alteration in the bilateral hippocampi (Fig. 1). Long-term video-electroencephalography (EEG) monitoring revealed interictal epileptiform discharges in the left anterior temporal lesion (Fig. 2); however, no ictal onset could be localized. Interictal 99mTc-ethyl cysteinate dimer (99mTc-ECD) single-photon emission computed tomography (SPECT) revealed decreased cerebral blood flow in the mesial left temporal lobe. Ictal ECD SPECT was not performed because of technical limitations.

Bottom Line: We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst.Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus.Hippocampal sclerosis was histopathologically confirmed (dual pathology).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Tsukuba University Hospital, Japan.

ABSTRACT
Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst.

No MeSH data available.


Related in: MedlinePlus