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Mesial Temporal Lobe Epilepsy in Congenital Toxoplasmosis: A Case Report.

Jeong WK, Joo BE, Seo JH, Mun JK, Kim J, Seo DW - J Epilepsy Res (2015)

Bottom Line: Her brain imaging findings revealed not only the multifocal encephalomalacia, but also multifocal cerebral calcification including intracerebral calcification in left perihippocampal region.Her epileptogenic zone was defined as mesial temporal lobe including hippocampus on left side by seizure semiology, electroencephalogram and neuroimaging including single photon emission computed tomography and 18F-Fluorodeoxyglucose positron-emission tomography.Her seizures were refractory to multiple anti-epileptic drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Toxoplasmosis is a rare disease caused by intracellular protozoan parasite, Toxoplasma gondii. Though most patients with toxoplasmosis are asymptomatic, congenital toxoplasmosis in the fetus can cause ocular involvement such as chorioretinitis and central nervous system disease including intracerebral calcification, nystagmus, hydrocephalus and microcephaly. Also, these brain lesions can cause seizure secondarily. Our patient was diagnosed with congenital toxoplasmosis, based on toxoplasma-specific serologic test with typical clinical symptoms, including chorioretinitis, nystagmus, hydrocephalus and cerebral palsy. Her brain imaging findings revealed not only the multifocal encephalomalacia, but also multifocal cerebral calcification including intracerebral calcification in left perihippocampal region. Her epileptogenic zone was defined as mesial temporal lobe including hippocampus on left side by seizure semiology, electroencephalogram and neuroimaging including single photon emission computed tomography and 18F-Fluorodeoxyglucose positron-emission tomography. Her seizures were refractory to multiple anti-epileptic drugs. We report a patient with congenital toxoplasmosis who showed intractable mesial temporal lobe epilepsy.

No MeSH data available.


Related in: MedlinePlus

Fundus photography in a patient with congenital toxoplasmosis. (A) Image shows macular inferior chorioretinal scar in right eye. (B) Image reveals large gray-whitish retinal necrotic lesion on posterior pole in left eye.
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f1-er-5-1-25: Fundus photography in a patient with congenital toxoplasmosis. (A) Image shows macular inferior chorioretinal scar in right eye. (B) Image reveals large gray-whitish retinal necrotic lesion on posterior pole in left eye.

Mentions: In a neurological examination, contracture and weakness of right arm and leg was found compatible with cerebral palsy. Her mental status was evaluated using Mini-Mental State Examination with the help of a translator and her score was 22, suggesting memory impairment and inattention. In ophthalmologic evaluation for visual impairment, macular inferior chorioretinal scar in right eye and large gray-whitish retinal necrotic lesion on posterior pole in left eye was found compatible with chorioretinitis which was characteristic finding usually seen in the patients with congenital toxoplasmosis (Fig. 1A, B). In serologic test using enzyme linked fluorescent assay, toxoplasma-specific IgG test was positive and IgM test was negative, suggesting chronic phase of T. gondii infection.6


Mesial Temporal Lobe Epilepsy in Congenital Toxoplasmosis: A Case Report.

Jeong WK, Joo BE, Seo JH, Mun JK, Kim J, Seo DW - J Epilepsy Res (2015)

Fundus photography in a patient with congenital toxoplasmosis. (A) Image shows macular inferior chorioretinal scar in right eye. (B) Image reveals large gray-whitish retinal necrotic lesion on posterior pole in left eye.
© Copyright Policy
Related In: Results  -  Collection

License
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getmorefigures.php?uid=PMC4494993&req=5

f1-er-5-1-25: Fundus photography in a patient with congenital toxoplasmosis. (A) Image shows macular inferior chorioretinal scar in right eye. (B) Image reveals large gray-whitish retinal necrotic lesion on posterior pole in left eye.
Mentions: In a neurological examination, contracture and weakness of right arm and leg was found compatible with cerebral palsy. Her mental status was evaluated using Mini-Mental State Examination with the help of a translator and her score was 22, suggesting memory impairment and inattention. In ophthalmologic evaluation for visual impairment, macular inferior chorioretinal scar in right eye and large gray-whitish retinal necrotic lesion on posterior pole in left eye was found compatible with chorioretinitis which was characteristic finding usually seen in the patients with congenital toxoplasmosis (Fig. 1A, B). In serologic test using enzyme linked fluorescent assay, toxoplasma-specific IgG test was positive and IgM test was negative, suggesting chronic phase of T. gondii infection.6

Bottom Line: Her brain imaging findings revealed not only the multifocal encephalomalacia, but also multifocal cerebral calcification including intracerebral calcification in left perihippocampal region.Her epileptogenic zone was defined as mesial temporal lobe including hippocampus on left side by seizure semiology, electroencephalogram and neuroimaging including single photon emission computed tomography and 18F-Fluorodeoxyglucose positron-emission tomography.Her seizures were refractory to multiple anti-epileptic drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Toxoplasmosis is a rare disease caused by intracellular protozoan parasite, Toxoplasma gondii. Though most patients with toxoplasmosis are asymptomatic, congenital toxoplasmosis in the fetus can cause ocular involvement such as chorioretinitis and central nervous system disease including intracerebral calcification, nystagmus, hydrocephalus and microcephaly. Also, these brain lesions can cause seizure secondarily. Our patient was diagnosed with congenital toxoplasmosis, based on toxoplasma-specific serologic test with typical clinical symptoms, including chorioretinitis, nystagmus, hydrocephalus and cerebral palsy. Her brain imaging findings revealed not only the multifocal encephalomalacia, but also multifocal cerebral calcification including intracerebral calcification in left perihippocampal region. Her epileptogenic zone was defined as mesial temporal lobe including hippocampus on left side by seizure semiology, electroencephalogram and neuroimaging including single photon emission computed tomography and 18F-Fluorodeoxyglucose positron-emission tomography. Her seizures were refractory to multiple anti-epileptic drugs. We report a patient with congenital toxoplasmosis who showed intractable mesial temporal lobe epilepsy.

No MeSH data available.


Related in: MedlinePlus