Pontine activation during focal status epilepticus secondary to hamartoma of the floor of the fourth ventricle

Pontes-Neto, Octávio M.; Wichert‐Ana, Lauro; Velasco, Tonicarlo Rodrigues; Bustamante, Guilherme; Fernandes, Regina Maria França; Azevedo-Marques, Paulo Mazzoncini de; Oliveira, Luis Carlos Origa de; Santos, Antônio Carlos dos; Kato, Mery; Inuzuka, Luciana Midori; Machado, Hélio Rubens; Sakamoto, Américo Ceiki

doi:10.1016/j.eplepsyres.2005.11.010

Cited by 23 publications

(25 citation statements)

References 7 publications

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“…Hamartomatous lesions have not commonly been described [1,8,9,10,11]. In all reported cases, the lesions seemed to be stable.…”

Section: Discussionmentioning

confidence: 74%

“…Their recording showed only diffuse fast activity and no epileptiform activity. This was conclusively later shown to be paroxysmal rhythmic activity similar to epileptic discharges [9,10,11]. However, it has to be remembered that clinical correlation is not possible in all these cases as the patient is under general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, a total of 14 cases of neuronal lesions of the fourth ventricle wall have been published to date in the English-language literature, including our own case [1,2,3,4,5,6,7,8,9,10,11]. The clinical semiology has been similar for most of the cases, including several episodes of attacks of hemifacial contraction involving the face and eyes, nystagmoid jerks of both eyes, eyelid blinking, upper limb involvement and autonomic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Fourth Ventricular Hamartoma Presenting with Status Epilepticus Treated with Emergency Surgery in an Infant

Chandra

Gulati²,

Kalra³

et al. 2011

Pediatr Neurosurg

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A 4-week-old infant presented with hemifacial spasms noticed from the 4th day after delivery. These progressed in severity, with generalization every 3–4 h. On admission, the infant went into refractory status epilepticus and had to be electively ventilated and taken for surgery on a semi-emergency basis. MRI showed a fourth ventricular hamartoma and video EEG showed spikes that were synchronous with the facial ‘twitches’ with generalization. Following the first surgery, the infant had an initial complete recovery, but developed recurrence of facial twitches after 2 weeks. Repeat MRI showed a small residual tumor which was re-operated and completely excised (at 8 weeks). Following this, the patient had complete recovery from seizures (5-year follow-up). This is the youngest patient reported presenting with status epilepticus with a fourth ventricular hamartoma operated successfully.

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“…Hamartomatous lesions have not commonly been described [1,8,9,10,11]. In all reported cases, the lesions seemed to be stable.…”

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fourth Ventricular Hamartoma Presenting with Status Epilepticus Treated with Emergency Surgery in an Infant

Chandra

Gulati²,

Kalra³

et al. 2011

Pediatr Neurosurg

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show abstract

“…There was no radiological evidence of a direct mechanical effect (compression) by the lesion on the brainstem nuclei. Previous reports of ictal hyperperfusion in both the cerebellar lesion and pons, support this hypothesis (Pontes-Neto et al, 2006). Furthermore, complete surgical resection or disconnection of the lesion result in clinical improvement with about 80% seizure freedom (Delande et al, 2001;Pontes-Neto et al, 2006).…”

Section: Discussionmentioning

confidence: 75%

“…Previous reports of ictal hyperperfusion in both the cerebellar lesion and pons, support this hypothesis (Pontes-Neto et al, 2006). Furthermore, complete surgical resection or disconnection of the lesion result in clinical improvement with about 80% seizure freedom (Delande et al, 2001;Pontes-Neto et al, 2006). Conversely, patients with partial lesion removal did not benefit from seizure reduction after surgery (Chae et al, 2001;Park et al, 2009).…”

Section: Discussionmentioning

confidence: 82%

Tracking the source of cerebellar epilepsy: Hemifacial seizures associated with cerebellar cortical dysplasia

Lascano¹,

Lemkaddem²,

Granziera³

et al. 2013

Epilepsy Research

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Summary Traditionally, subcortical structures such as the cerebellum are supposed to exert a modulatory effect on epileptic seizures, rather than being the primary seizure generator. We report a 14-month old girl presenting, since birth, with seizures symptomatic of a right cerebellar dysplasia, manifested as paroxystic contralateral hemifacial spasm and ipsilateral facial weakness. Multimodal imaging was used to investigate both anatomical landmarks related to the cerebellar lesion and mechanisms underlying seizure generation. Electric source imaging (ESI) supported the hypothesis of a right cerebellar epileptogenic generator in concordance with nuclear imaging findings; subsequently validated by intra-operative intralesional recordings. Diffusion spectrum imaging-related tractography (DSI) showed severe cerebellar structural abnormalities confirmed by histological examination. We suggest that hemispheric cerebellar lesions in cases like this are likely to cause epilepsy via an effect on the facial nuclei through ipsilateral and contralateral aberrant connections.

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Fourth ventricle hamartoma presenting with progressive myoclonus and hemifacial spasms: case report and review of literature

et al. 2011

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Pontine activation during focal status epilepticus secondary to hamartoma of the floor of the fourth ventricle

Cited by 23 publications

References 7 publications

Fourth Ventricular Hamartoma Presenting with Status Epilepticus Treated with Emergency Surgery in an Infant

Fourth Ventricular Hamartoma Presenting with Status Epilepticus Treated with Emergency Surgery in an Infant

Tracking the source of cerebellar epilepsy: Hemifacial seizures associated with cerebellar cortical dysplasia

Fourth ventricle hamartoma presenting with progressive myoclonus and hemifacial spasms: case report and review of literature

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