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[Late onset epilepsy associated with migration disorder: a case report].
Shin-ichi Imamura1, Tatsui Nagado, Yuji Toyomitsu
1Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
No to Shinkei = Brain and Nerve
|March 8, 2006
Summary
This report details the first case of mesiotemporal lobe epilepsy linked to a migration disorder in a patient over 50. Effective medication therapy resolved the patient's frequent seizures.
Area of Science:
- Neurology
- Neuroscience
- Epileptology
Background:
- Late-onset epilepsy is uncommon, particularly in individuals over 50.
- Mesiotemporal lobe epilepsy (MTLE) is a common focal epilepsy, often associated with hippocampal sclerosis.
- Migration disorders, such as focal cortical dysplasia (FCD), are recognized causes of epilepsy, typically in younger individuals.
Observation:
- A 57-year-old female presented with new-onset, frequent seizures characterized by motionless staring and oral automatism.
- Electroencephalograms (EEGs) revealed characteristic spikes in the right sphenoidal derivation.
- Magnetic resonance imaging (MRI) identified an abnormal region in the brain, suggestive of a focal cortical dysplasia.
Findings:
- The patient was diagnosed with mesiotemporal lobe epilepsy (MTLE) associated with a probable focal cortical dysplasia (FCD).
- This represents a novel association, as epilepsy linked to migration disorders is rarely reported in patients over 50.
- Seizure activity completely resolved following appropriate anti-epileptic medication therapy.
Implications:
- This case highlights that migration disorders should be considered in the differential diagnosis of late-onset epilepsy.
- The findings expand the known spectrum of epilepsy etiologies and age of onset for migration-related epilepsy.
- Further research is warranted to understand the mechanisms underlying late-onset epilepsy associated with cortical malformations.