Related Experiment Videos
Diencephalic epilepsy with congenital suprasellar arachnoid cyst in an infant
M Giroud1, J L Sautreaux, A Thierry
1Service de Neurologie, Hôpital Général, Dijon, France.
Insights
A congenital suprasellar arachnoid cyst caused diencephalic seizures in an infant. Surgical intervention resolved the seizures, highlighting the cyst-seizure relationship.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Pediatric Neurosurgery
Background:
- Diencephalic seizures are rare, often presenting with autonomic and behavioral symptoms.
- Intracranial hypertension and specific radiological findings can indicate underlying structural causes.
Observation:
- A 2-year-old infant experienced paroxysmal episodes of drowsiness, cyanosis, and bradycardia, suggestive of diencephalic seizures.
- Head bobbing during drowsiness and normal EEG contrasted with radiographic evidence of intracranial hypertension and hydrocephalus.
Findings:
- A CT scan revealed hydrocephalus secondary to a congenital suprasellar arachnoid cyst.
- Histological examination confirmed the cyst as arachnoid in origin.
- Surgical decompression of the cyst led to complete resolution of seizures and head bobbing.
Implications:
- This case demonstrates a direct causal link between suprasellar arachnoid cysts and diencephalic seizures.
- Highlights the importance of neuroimaging in diagnosing rare epilepsy syndromes.
- Emphasizes surgical management for effective treatment of cyst-induced neurological deficits.
Abstract:
The authors report the case of a 2-year-old infant who presented with paroxysm and short changes characterized by acute drowsiness, cold sweats, ocular reversion, facial cyanosis, and bradycardia. Between these attacks, the condition was normal, suggesting diencephalic seizures. Over 2 months five fits were observed by the parents when some to-and-fro bobbing of the head onto the trunk appeared during drowsiness. One electroencephalogram was normal without a slow background or spikes discharges. As the skull radiographs showed erosion of the jugum and chronic intracranial hypertension features, a CT scan was performed and showed hydrocephalus associated with a congenital suprasellar cyst. The cyst was opened into basal cisterns with cystoperitoneal shunt. The histological examination revealed that it was an arachnoid cyst. Six months later, the infant was free of diencephalic seizures and head bobbing. Thus, we can assert that there was a direct relationship between this cyst and the diencephalic seizures. From this case, the authors make a review of the clinical features of diencephalic epilepsy, and their different causes and show that both diencephalic epilepsy and suprasellar arachnoid cysts are not common.