Case 284: Posterior Quadrantic Dysplasia

Radiology
Matthew KlumppAtin Goel

Abstract

History A 36-year-old left-handed woman with a history of developmental delay and medical refractory seizures since birth most recently presented with continuous simple partial seizures and occasional breakthrough complex partial seizures with postictal migraines. These were described as the patient "becoming pale with sinking to the floor and staring for approximately 1 minute with confusion thereafter." The patient had years of reported seizure freedom until 2010 when she was evaluated for intractable headaches, and electroencephalography revealed her focal subclinical status. At that time, ambulatory electroencephalography findings showed asymmetric left parietal-occipital high-amplitude spike-and-wave discharges in her best awake and alert state. Since that time, the patient developed and continues to have complex partial seizures every 2-3 months that are persistent despite the implementation of several medical regimens. At the time of recent presentation, the patient initially underwent unenhanced head CT in the emergency department followed by unenhanced MRI of the brain due to increased seizure activity at the patient's group home despite continued compliance with her antiepileptic regimen. Contrast material-enhanced im...Continue Reading

References

Oct 19, 2010·Seizure : the Journal of the British Epilepsy Association·F NovegnoF Guzzetta
Jan 25, 2014·Lancet Neurology·Sophia VaradkarJ Helen Cross
Sep 3, 2014·Epileptic Disorders : International Epilepsy Journal with Videotape·Peng-Fan YangZhi-Yong Zheng
Oct 10, 2014·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·G TamburriniC Di Rocco

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