[An infant with multiple cavernous angiomas presenting with frequent epileptic seizures - detection of epileptic focus by magnetoencephalography].
We report on a six-year-old girl with frequent partial seizures secondary to multiple cavernous angiomas (CAs) since the age of 17 months. MRI showed two CAs in the left parietal and right frontal lobes. Ictal scalp video EEG demonstrated complex partial seizures of left hemispheric origin, indicating that the left parietal CA was the epileptogenic lesion. Ictal SPECT showed extensive hyper-perfusion in the left frontal and parietal lobes, indicating the left hemispheric focus. Magnetoencephalography (MEG) showed clustered equivalent current dipoles of interictal spikes in the left parietal cortex adjacent to the left parietal CA. We performed lesionectomy of the left parietal CA at 19 months old. The patient became seizure-free for four years. Postoperative MEG yielded no residual interictal spikes. Our study suggests that early surgical intervention of CA may prevent from further development of epileptic seizures. MEG can identify both the epileptogenic zone and lesion underlying the multiple CAs in the infants with catastrophic partial seizures.
Tohyama
Jun
J
Department of Pediatrics, Nishi-Niigata Chuo National Hospital. jtohyama@masa.go.jp
Akasaka
Noriyuki
N
Saito
Naka
N
Kanazawa
Osamu
O
Morota
Nobuhito
N
Kameyama
Shigeki
S
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D010296:Parietal Lobe / Q000502:physiology / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon