Case 92 -- Seven Year Old Girl with Seizures

Contributed by Hindi Al-Hindi, MD.1, Brian Subach, MD.2, and Ronald L. Hamilton, MD.1
Published on line in February 1997

University of Pittsburgh and Children's Hospital of Pittsburgh,
Departments of Pathology (Neuropathology)1 and Neurosurgery2



PATIENT HISTORY:

This seven year old, right handed, white female presented with a 6-month history of partial complex seizures of increasing frequency, which were eventually controlled with Tegretol. The typical seizure episode was short, lasting only 20-30 seconds, but was followed by a prolonged postictal state. Physical examination was essentially normal and there were no focal neurological deficits. An MRI scan was obtained.


NEUROIMAGING:

T-1 weighted MRI images demonstrated hypointense white matter signal in the left temporal lobe. The overlying cortex was distinct, but thinned and slightly hyperintense when compared to nearby cortical grey matter. T-2 weighted images showed this area to be hyperintense and the lesion was quite distinct on coronal and horizontal cuts. The lesion showed no contrast enhancement


GROSS DESCRIPTION

MICROSCOPIC DESCRIPTION

FINAL DIAGNOSIS


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