A Giant Porencephaly: A Rare Etiology of Pediatric Seizures

Abstract

Pediatric convulsive seizure is common and represents a source of major concern and anxiety for the parents. Seizures can have a broad spectrum of etiologies in children, including metabolic, traumatic, developmental, and infectious causes. Depending on the clinical presentation, laboratory testing and neuroimaging may be indicated in the workup of the first unprovoked afebrile seizure. We present a case of a six-year-old boy who was brought to the emergency department by his mother after an episode of convulsion. She reported that he had jerky repetitive movements of all extremities that lasted around two minutes with spontaneous termination. The child did not have a febrile illness. The mother reported no history of similar episodes. Upon examination, the child appeared alert and conscious. No dysmorphic features were evident. Initial laboratory investigations were within the normal limits. The child underwent magnetic resonance imaging for the brain, which demonstrated a large well-defined extra-axial cystic lesion occupying most of the left hemisphere that is connected to the ventricular system. The lesion had no grey-matter lining and it strictly followed the cerebrospinal fluid in all sequences. Such finding represented the diagnosis of a giant left porencephalic cyst. Porencephaly is an extremely rare neurological anomaly that may present with pediatric seizures. Magnetic resonance imaging is the gold standard modality for the diagnosis of porencephaly. The case demonstrated that porencephaly can have a massive size in a patient with normal psychoneurological development.

Molluscum Contagiosum Masquerading: Diagnosing Giant Lesions in an Unfamiliar Territory

“…Atypical lesions of MC may occur in patients with altered or impaired immunity, such as those with atopic dermatitis, after long-term use of corticosteroids and immunosuppressive therapy, sarcoidosis, leukemias and especially in patients with acquired immune deficiency syndrome. 1,[7][8][9][10] These lesions can mimic a wide range of other conditions and often grow to a large size on an unusual site.…”

Post-traumatic cysts detected by ultrasound in infant presented with first-time seizures: Case report

“…Porencephaly can occur in any lobe. Although most cases are unilateral, bilateral porencephaly has been reported [9] . The clinical manifestations of porencephaly vary and may be related to the site and size of the lesion [9] .…”

“…Although most cases are unilateral, bilateral porencephaly has been reported [9] . The clinical manifestations of porencephaly vary and may be related to the site and size of the lesion [9] . In this report, we describe an 8-month-old infant who presented with seizures post a traumatic head injury.…”

The Concise Guide to PHARMACOLOGY 2023/24: Transporters

“…-Ala-Lys-AMCA [4,12,13,169,423,614,623,683,694,856,857], alafosfalin [536], Javamide-I(N-coumaroyltryptophan)/-II(N-caffeoyltryptophan) esters (javamide-I-O-methyl ester and javamide-II-O-methyl ester), acetylated prolyl-glycyl-proline (Ac-PGP; the acetylated form of the collagen-derived matrikine PGP) [610], mirogabalin [817] Endogenous substrates 5-aminolevulinic acid […”

“…Two families (SLC3 and SLC7) only generate functional transporters as heteromeric partners, where one partner is a single TM domain protein. Membrane topology predictions for other families suggest 3,4,6,7,8,9,10,11,12,13 or 14 TM domains. The SLC transporters include members which function as antiports, where solute movement in one direction is balanced by a solute moving in the reverse direction.…”