Within five weeks: Rapidly grown glioblastoma discovered on repeat MRI after pathologic EEG
Related Experiment Video
Updated: May 22, 2025
Translational Orthotopic Models of Glioblastoma Multiforme
Published on: February 17, 2023
Zsuzsanna Szankai1, Egle Huggenberger1, Christoph Metzler2
1Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland.
Background:
According to the recommendations of the International League against Epilepsy, a timely workup with a brain MRI is recommended after a first epileptic seizure. However, if the MRI is unrevealing, it is normally not repeated.
Case Presentation:
We present a patient with an unprovoked epileptic seizure and only slight focal abnormalities in the EEG and a normal brain MRI. Only 35 days later, after a third seizure and now a focally pathological EEG, we repeated the brain MRI and discovered a large mass in the left temporal lobe, which was resected and histologically classified as glioblastoma multiforme.
Conclusion:
This case of a very fast-growing tumor suggests that recurrent seizures, with or without anti-seizure medications, or new changes in the EEG should prompt the clinician to consider a repeat brain MRI, even if the first scan was normal.
Insights
A repeat brain MRI is recommended after a first epileptic seizure if initial scans are normal. This case highlights a fast-growing glioblastoma missed on the first MRI, emphasizing the need for re-imaging with seizure recurrence or EEG changes.
Area of Science:
- Neurology
- Neuro-oncology
- Diagnostic Imaging
Background:
- International League against Epilepsy guidelines recommend brain MRI after a first epileptic seizure.
- Typically, a normal initial MRI is not repeated, even if seizures persist.
