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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

Brain MRI and CT. (A) and (B) Coronal FLAIR MRI shows multifocal encephalomalacic change related to VP shunt (wide long arrow), left hippocampal sclerosis (wide short arrow) and left amygdala hypertrophy (thin long arrow) and intracerebral calcification (thin short arrow) adjacent to hippocampus. (C) and (D) Axial CT demonstrates multiple intracerebral calcification in left perihippocampal region, periventricular and subcortical white matter. CT, computed tomography; MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery; VP, ventriculoperitoneal.
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f2-er-5-1-25: Brain MRI and CT. (A) and (B) Coronal FLAIR MRI shows multifocal encephalomalacic change related to VP shunt (wide long arrow), left hippocampal sclerosis (wide short arrow) and left amygdala hypertrophy (thin long arrow) and intracerebral calcification (thin short arrow) adjacent to hippocampus. (C) and (D) Axial CT demonstrates multiple intracerebral calcification in left perihippocampal region, periventricular and subcortical white matter. CT, computed tomography; MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery; VP, ventriculoperitoneal.


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)

Brain MRI and CT. (A) and (B) Coronal FLAIR MRI shows multifocal encephalomalacic change related to VP shunt (wide long arrow), left hippocampal sclerosis (wide short arrow) and left amygdala hypertrophy (thin long arrow) and intracerebral calcification (thin short arrow) adjacent to hippocampus. (C) and (D) Axial CT demonstrates multiple intracerebral calcification in left perihippocampal region, periventricular and subcortical white matter. CT, computed tomography; MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery; VP, ventriculoperitoneal.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494993&req=5

f2-er-5-1-25: Brain MRI and CT. (A) and (B) Coronal FLAIR MRI shows multifocal encephalomalacic change related to VP shunt (wide long arrow), left hippocampal sclerosis (wide short arrow) and left amygdala hypertrophy (thin long arrow) and intracerebral calcification (thin short arrow) adjacent to hippocampus. (C) and (D) Axial CT demonstrates multiple intracerebral calcification in left perihippocampal region, periventricular and subcortical white matter. CT, computed tomography; MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery; VP, ventriculoperitoneal.
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