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[Insular psammomatous meningioma presenting intractable complex partial seizures]

Hirochika Imoto1, Masami Fujii, Yuichi Maruta

  • 1Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.

No Shinkei Geka. Neurological Surgery
|August 24, 2012
PubMed

Insights

A calcified insular psammomatous meningioma caused intractable epilepsy in a 30-year-old female. Surgical removal of the tumor led to complete seizure resolution without neurological deficits, highlighting effective treatment.

Area of Science:

  • Neurosurgery
  • Neurology
  • Pathology

Background:

  • Epilepsy is a neurological disorder characterized by recurrent seizures.
  • Insular brain lesions can present with complex partial seizures mimicking other epilepsy types.
  • Meningiomas are tumors arising from the meninges, the membranes surrounding the brain and spinal cord.

Observation:

  • A 30-year-old female presented with intractable symptomatic epilepsy.
  • The epilepsy was caused by a calcified mass in the insular region of the brain.
  • Histological examination confirmed the mass as a psammomatous meningioma.

Findings:

  • The patient experienced seizures characterized by impaired consciousness, motionless stare, and automatism.
  • Surgical resection of the insular meningioma was performed using neuronavigation and motor evoked potential (MEP) monitoring.
  • Complete removal of the tumor resulted in the complete cessation of seizures.
  • No neurological deficits were observed post-operatively.

Implications:

  • Insular meningiomas can manifest as complex partial seizures that closely resemble medial temporal lobe epilepsy.
  • Total surgical resection is an effective treatment for epilepsy caused by insular meningiomas.
  • This case underscores the importance of considering rare intracranial lesions in the differential diagnosis of refractory epilepsy.

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