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[A case with mild subdural hematoma presenting with a transient cluster of convulsions--problems concerning

C Nakazawa1, S Tanaka, H Yokoyama

  • 1Department of Pediatrics, National Sendai Hospital.

No to Hattatsu = Brain and Development
|August 1, 2000
PubMed

Insights

This study reports a case of infantile seizures where MRI revealed subdural hematomas, suggesting serial imaging for benign infantile convulsion and epilepsy diagnoses.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Epileptology

Background:

  • Infantile seizures require accurate diagnosis to differentiate benign conditions from those with potential sequelae.
  • Electroencephalography (EEG) and computed tomography (CT) are standard initial diagnostic tools.

Observation:

  • A 1-month-old infant presented with frequent partial seizures and continuous left central EEG spikes during ictal periods.
  • Initial EEG and CT scans were unremarkable for focal signs or abnormalities.
  • Magnetic Resonance Imaging (MRI) performed 10 days later revealed subdural hematomas in the left front-temporal and right occipital regions.

Findings:

  • The patient's seizures were effectively managed with diazepam and phenobarbital.
  • Neurological examination post-seizure and after treatment showed no deficits or sequelae.
  • The presence of subdural hematomas on MRI, despite initial normal imaging, is a key finding.

Implications:

  • This case highlights the potential for delayed detection of intracranial pathology like subdural hematomas in infants presenting with seizures.
  • Serial neuroradiological examinations, particularly MRI, may be crucial for accurate diagnosis in cases initially suspected as benign infantile convulsion or benign complex partial epilepsies.
  • Further prospective studies are warranted to establish the role of serial imaging in managing infantile epilepsy syndromes.

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