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Clinical reasoning: a 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades


Tonder, Michaela; Rushing, Elisabeth Jane; Grotzer, Michael; Sürücü, Oguzkan; Valavanis, Antonios; Buck, Alfred; Weller, Michael; Roth, Patrick (2014). Clinical reasoning: a 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades. Neurology, 82(7):e56-e60.

Abstract

A 30-year-old woman presented with a history of generalized tonic-clonic seizures since childhood, occurring for the first time at age 9. The initial diagnostic workup at age 13 demonstrated a distinctive calcified mass of the left frontal lobe on CT (figure, A). Together with a single facial nevus, the lesion was suspected to represent Sturge-Weber-like phakomatosis; however, the patient's clinical history and physical examination failed to reveal further evidence of a neurocutaneous syndrome. Neither MRI nor biopsy for histologic confirmation of the diagnosis was performed. At age 18 the patient was lost to follow-up at the children's hospital.

A 30-year-old woman presented with a history of generalized tonic-clonic seizures since childhood, occurring for the first time at age 9. The initial diagnostic workup at age 13 demonstrated a distinctive calcified mass of the left frontal lobe on CT (figure, A). Together with a single facial nevus, the lesion was suspected to represent Sturge-Weber-like phakomatosis; however, the patient's clinical history and physical examination failed to reveal further evidence of a neurocutaneous syndrome. Neither MRI nor biopsy for histologic confirmation of the diagnosis was performed. At age 18 the patient was lost to follow-up at the children's hospital.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neuroradiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
04 Faculty of Medicine > University Hospital Zurich > Institute of Neuropathology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2014
Deposited On:09 Jul 2014 14:53
Last Modified:05 Apr 2016 17:50
Publisher:Lippincott, Williams & Wilkins
ISSN:0028-3878
Additional Information:This is a non-final version of an article published in final form in Neurology February 18, 2014 vol. 82 no. 7 e56-e60.
Publisher DOI:https://doi.org/10.1212/WNL.0000000000000122
PubMed ID:24536067
Permanent URL: https://doi.org/10.5167/uzh-95407

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