Structural Focal Epilepsy Or Idiopathic Generalised Epilepsy?
Case presentation: A 17-year-old boy with no previous health problems was referred to our hospital to be evaluated for epilepsy surgery. It was reported that he had seizures for the first time at the age of 15 after prolonged computer exposure, he had myoclonic seizures, and first, lamotrigine and then valproic acid treatments were administered. Brain magnetic resonance imaging showed a hyperintense lesion in T2 sequences with contrast enhancement in the superior part of the right parietooccipital sulcus. The patient was admitted to our video-EEG unit. Interictal EEG showed spike-wave discharges with a frequency of 2.5-3 Hz and ictal EEG showed generalized multiple spike discharges and generalized myoclonic jerks. Juvenile myoclonic epilepsy was considered after the epilepsy surgery meeting. Valporic acid dose was increased and he was monitored without seizures. The oncology department suggested that the lesion should be resected in the subsequent period. After an uneventful operation, he experienced only one seizure on a day when he was sleep-deprived and did not take his medication. Conclusion: Patients with epilepsy should be carefully evaluated. It should be kept in mind that patients with idiopathic generalized epilepsies may have concomitant lesions.
Ceren Günbey
Hacettepe University Faculty of Medicine
Turkey
Burçak Bilginer
Hacettepe University Faculty of Medicine
Turkey
Kader Karlı Oğuz
Hacettepe University Faculty of Medicine
Turkey
Dilek Yalnızoğlu
Hacettepe University Faculty of Medicine
Turkey
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