Skip to main content
  Sign In   Register

ePoster Presentations Proceedings »
Supporting Data
View File
docx
4.1MB

Intractable epilepsy due to cerebellar ganglioneural hamartoma: Evidence for seizures originating from cerebellum

Objective: Although the traditional knowledge of epilepsy localizes the origin of seizures solely to cerebral cortex, there is evidence for epileptic seizures originating from subcortical structures including cerebellum. Methods: A four-year-old male patient admitted for intractable seizures that had been ongoing since birth. The cranial MRI revealed a cerebellar mass lesion. Results: Semiological features of the events were the deviation of the head and eyes to right, pulling of the corner of the mouth to left, and flexion of the left arm. The events occurred hundred times a day and were resistant to antiepileptic drug therapy including bromide and CBD oil. Since the ictal and interictal EEGs were not informative, the paroxysmal phenomenon was classified as hemifacial spasm. The duration of the events gradually became longer with mild impairment of consciousness and cognitive impairment occurred. Although the electroclinical signature of the events was not clear, generalized voltage attenuation predominant at the right hemisphere was consistently evident in all events. PET/CT revealed a hypermetabolic focal lesion in the right cerebellar peduncle compatible with the cranial-MRI (Figure-1). Due to the ongoing seizures despite medical treatment, cognitive impairment and the probable epileptic origin of the cerebellar mass, surgical resection was performed. The histopathology resulted as ganglioneural hamartoma. The case is seizure free for 18 months without anti-seizure drugs. Conclusion: Cerebellar lesions can cause epilepsy especially when they are in close proximity to the cerebellar peduncles. Surgical resection offers a chance of seizure-freedom and excellent prognosis early in life if complete resection is achieved.
Keywords: cerebellar hamartoma, ganglioneural hamartoma, cerebellar epilepsy

Sanem Yilmaz
Ege University Medical Faculty
Turkey

Cemile Busra Olculu
Ege University Medical Faculty
Turkey

Aylin Oral
Ege University Medical Faculty
Turkey

Erdem Simsek
Hatay Training and Research Hospital
Turkey

Omer Kitis
Ege University Medical Faculty
Turkey

Seda Kanmaz
Ege University Medical Faculty
Turkey

Zeynep Burak
Ege University Medical Faculty
Turkey

Hepsen Mine Serin
Ege University Medical Faculty
Turkey

Gul Aktan
Ege University Medical Faculty
Turkey

Hasan Tekgul
Ege University Medical Faculty
Turkey

Sarenur Gokben
Ege University Medical Faculty
Turkey

Burcak Bilginer
Hacettepe University
Turkey

 

 


®2002-2021 ICNApedia