Turkish Neurosurgery 2020 , Vol 30 , Num 3
Surgically Treated Status Epilepticus due to Large Cortical Tuber and Long-Term Follow-Up Results
Gonul GUVENC1,Ceren KIZMAZOGLU2,Murat SAYIN1,Hatice Sabiha TURE3
1Izmir Katip Celebi University, Atatürk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
2Dokuz Eylul University, School of Medicine, Department of Neurosurgery, Izmir, Turkey
3Izmir Katip Celebi University, Atatürk Training and Research Hospital, Department of Neurology, Izmir, Turkey
DOI : 10.5137/1019-5149.JTN.21343-17.2 We present a case of invasive monitoring of a patient while he was being surgically treated in the status state. Our patient was a 27-year-old male who was hospitalized for frequent seizures, which began after a head trauma at the age of 3 years. Video electroencephalography was performed, and 25 clinical seizures were observed in 24 hours. Cranial magnetic resonance imaging (MRI) revealed a right frontal lesion which was hyperintense in T2-weighted and hypointense in T1-weighted images, and a subependymal nodule. For invasive monitoring, subdural electrodes were placed on the cortex surface via a right frontal craniotomy. The patient was re-operated, and the epileptic zone resection was performed. There was no sign of neurological deficit. Histopathological examination revealed cortical tuber, and the patient was scanned for tuberous sclerosis. There was no sign of tuberous sclerosis in other organs. The diagnosis of our patient was tuberous sclerosis, cortical tuber, subependymal nodule, epilepsy, and intermediate mental retardation. Radiological diagnosis should also be considered. Cortical tuber can be confused with focal cortical dysplasia. Finally, staged resection may be performed as a surgical treatment in some cases. Keywords : Cortical tuber, Electroencephalography, Frontal lobe epilepsy, Invasive recording, Tuberous sclerosis
Corresponding author : Murat SAYIN, smsayin@gmail.com