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[Solitary cerebral varix. Case report].

T Nishioka1, A Kondo, K Nin

  • 1Department of Neurosurgery, Kitano Hospital, Osaka.

Neurologia Medico-Chirurgica
|January 1, 1990
PubMed
Summary

A 69-year-old man experienced focal seizures due to a left insular lesion. Treatment with phenytoin significantly reduced seizure frequency, indicating a potential therapeutic response.

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Area of Science:

  • Neurology
  • Neuroradiology

Background:

  • Focal seizures can originate from structural brain lesions.
  • The insular region is a complex area involved in various neurological functions.

Observation:

  • A 69-year-old male presented with a 4-month history of tonic seizures affecting the right arm and leg.
  • Electroencephalogram showed left frontal sharp wave activity.
  • Imaging revealed a left insular hyperdense lesion, with a posterior insular vein varix noted on angiography.
  • MRI T2-weighted images showed a subtle signal abnormality in the same area.

Findings:

  • A left insular lesion, potentially a venous malformation, was identified as the source of focal seizures.
  • Phenytoin administration led to a marked decrease in seizure frequency.

Implications:

  • This case highlights the importance of comprehensive neuroimaging in diagnosing the etiology of focal seizures.
  • Varicose dilatation of the posterior insular vein may be associated with focal epilepsy.
  • Phenytoin demonstrated efficacy in managing seizures attributed to this specific lesion.

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