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Cerebral venous thrombosis associated with recurrent epilepsy-like attacks
T Ichiyama1, S Houdou, Y Tomita
1Division of Child Neurology, Tottori University School of Medicine, Yonago, Japan.
Brain & Development
|January 1, 1989
Summary
Recurrent unconsciousness and seizures in a child were linked to cerebral venous thrombosis, not epilepsy. This rare condition mimics seizures but requires different diagnostic and treatment approaches.
Area of Science:
- Neurology
- Pediatric Neurology
- Vascular Neurology
Background:
- Recurrent episodes of unconsciousness and convulsions in children can present diagnostic challenges.
- Distinguishing between epileptic and non-epileptic causes is crucial for appropriate management.
- Cerebral venous thrombosis (CVT) is a rare but serious condition that can manifest with diverse neurological symptoms.
Observation:
- A 9-year-old girl experienced 9 episodes of unconsciousness with or without convulsions over 6 years.
- Episodes included generalized or hemi-convulsions, headache, vomiting, and prolonged disturbance of consciousness.
- Electroencephalogram (EEG) showed slow activity post-episode, but no epileptic discharges were detected.
- Anticonvulsant medications showed no prophylactic effect.
Findings:
- Cerebral angiography revealed characteristic corkscrew-like veins in the frontal region.
- The clinical presentation and imaging findings strongly suggested cerebral venous thrombosis (CVT).
- The absence of epileptic discharges on EEG further supported a non-epileptic etiology.
Implications:
- This case highlights the importance of considering CVT in pediatric patients with recurrent unexplained neurological events.
- Cerebral venous thrombosis should be included in the differential diagnosis for conditions mimicking epilepsy.
- Timely diagnosis and management of CVT are essential to prevent severe neurological sequelae.