1/7. June 2003: 33-year-old male with a frontal lobe mass.The June 2003 COM. A 33-year-old male with a history of seizures was found to have an intra- and extra-axial frontal lobe mass. The histology of the resected tumor showed a meningioma with underlying meningioangiomatosis. Meningioangiomatosis (MA) is a benign intracortical plaque-like proliferation of meningothelial cells, microvasculature and fibroblast-like cells probably of hamartomatous origin. Very rarely, MA is associated with an overlying meningioma as in this case. When MA is accompanied by a meningioma, it is generally not associated with clinical evidence of neurofibromatosis. It is important to distinguish MA from an invasive meningioma, because of its favorable prognosis after resection.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/7. MRI assessment of anterior callosotomy in the treatment of pharmacoresistant epilepsy.Section of the anterior two-thirds of the corpus callosum is a well-known treatment of some forms of epilepsy of long duration resistant to anti-epileptic drugs and dangerous for the patient (tonic and atonic seizures). The aim of this functional surgery is to obtain the most complete rostral and caudal section of the corpus callosum without risk of disconnection syndrome. Callosotomy is seldom performed in europe. We present our experience of magnetic resonance imaging (MRI) in the pre- and postoperative assessment of 6 patients who underwent anterior callosotomy and were followed up for more than six months. Our results were encouraging with considerable improvement of the patients' social life.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/7. Cardiac asystole during right frontal lobe seizures: a case report.The association between partial seizures and cardiac asystole has rarely been reported in the literature. This potentially life-threatening symptom has been observed principally in left-sided epilepsies, in particular during seizures originating in temporal lobe. We describe a case with ictal bradycardia followed by cardiac asystole during right frontal lobe seizures. Video-EEG monitoring recorded two partial seizures with electro-clinical findings suggestive of a right frontal lobe origin, associated with ictal bradycardia followed by prolonged asystole. The brain MRI showed a lesion located in the cingulate gyrus of the right frontal lobe. The patient required a subsequent placement of a pacemaker. In conclusion, cardiac asystole may be a potentially life-threatening symptom during seizures of frontal lobe origin. The right fronto-mesial structures may play a role in autonomic regulation of cardiovascular responses.- - - - - - - - - - ranking = 2keywords = life (Clic here for more details about this article) |
4/7. Hypersexuality in two patients with epilepsy treated with lamotrigine.PURPOSE: Lamotrigine (LTG) is a novel anticonvulsant drug that exerts an antiepileptic effect by decreasing glutamate release through inhibition of voltage-sensitive sodium channels. LTG has no effect on serum levels of most female reproductive hormones, but its effect on male reproductive hormones still remains unclear. Improvement in sexual function after LTG treatment has been reported, and could have been caused by reduction of seizures, inhibition of focal discharges, or an unknown effect of LTG on reproductive hormones and protein levels. CASES: Two male patients exhibited acute hypersexuality while taking lamotrigine as add-on therapy: one patient on carbamazepine and one on oxcarbazepine. Neither prior history of psychiatric illness nor brain damage predisposed them to such a response to treatment, and in both patients, the hypersexuality was not a part of hypomania or a more diffuse psychiatric disturbance. In the first case, sexual hyperactivity resolved after discontinuation of LTG therapy without any concomitant treatment. In the second case, a reduction in the dose of LTG decreased the intensity of the hypersexuality and contributed to the patient's increased satisfaction with his sex life. CONCLUSIONS: Lamotrigine may cause drug-related hypersexuality by an unclear underlying mechanism.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
5/7. Surgical treatment of intractable epilepsy associated with schizencephaly.With the advent of magnetic resonance imaging, there has been an increased recognition of schizencephaly during life, especially in epileptic patients. We report our experience with the assessment and treatment of three patients with medically intractable seizures associated with this condition. The three men were aged 24 to 37 years. Two had delayed developmental milestones and hemiparesis or hemiplegia. One had normal development and a normal neurological examination. seizures began between the ages of 15 and 19 years and lasted for 5 to 22 years before surgery. All had partial simple or generalized seizures with predominant electroencephalographic and electrocorticographic epileptic activity localized to temporal and frontal lobes on the side of the lesion. Neuropsychological assessment indicated widespread dysfunction maximal at the areas of predominant electroencephalographic abnormality. magnetic resonance imaging demonstrated anterior parasagittal, parietal, and Rolandic cerebral clefts, with ventricular diverticuli, gray matter heterotopia, polymicrogyria, and a true agenesis of the corpus callosum in individual patients. The patients underwent temporal (one patient) and frontotemporal (two patients) lobectomies without additional neurological deficits or neuropsychological deterioration. Postoperative follow-up showed reduction in seizure frequency. We conclude that the surgical treatment of epilepsy is well tolerated in such patients, and their seizures can be alleviated by resection of epileptogenic areas.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/7. Autosomal dominant frontal epilepsy misdiagnosed as sleep disorder.We describe a distinctive epilepsy syndrome in six families, which is the first partial epilepsy syndrome to follow single gene inheritance. The predominant seizure pattern had frontal lobe seizure semiology with clusters of brief motor attacks occurring in sleep. Onset was usually in childhood, often persisting through adult life. Misdiagnosis as night terrors, nightmares, hysteria, or paroxysmal nocturnal dystonia was common, and the inheritance pattern was often not appreciated. This autosomal dominant epilepsy syndrome is ideal for identification of partial epilepsy genes.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
7/7. phyllodes tumor in epileptics: a report of two cases.phyllodes tumor is an uncommon breast neoplasm characterized by a proliferation of both stromal and epithelial elements. In 1989, two young patients with phyllodes tumors were referred to our surgical department because of the detection of breast lumps. Interestingly, both patients also had epilepsy and had been taking anticonvulsants. An analytical case control study revealed that no significant difference between the control group and phyllodes group was found for various categories. In addition, no anticonvulsant medication had been prescribed in either the control group or the phyllodes group except for these two cases. We herein report two cases of phyllodes tumors occurring in two young epileptic patients.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |