Coeliac Disease, Occipital Calcifications and Drug Resistant Epilepsy. Successful Lesionectomy
Abstract number :
2.301
Submission category :
Year :
2001
Submission ID :
3061
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
K.O. Nakken, MD, PhD, The National Center for Epilepsy, Sandvika, Norway; G.K. Roeste, MD, PhD, Neurosurgery, The National Hospital, Oslo, Norway
RATIONALE: To demonstrate the value of lesionectomy in a patient with coeliac disease (CD), occipital calcifications and drug resistant epilepsy.
METHODS: The male patient had gastrointestinal symptoms from childhood. Nine years old CD was confirmed by intestinal biopsy. Although he was given a gluten-free regime, he did not comply with the diet, and his folic acid levels were constantly low. A new intestinal biopsy taken when he was 28 years old, revealed continued atrophy of the villi. His HLA phenotype was DQw2, which is associated with susceptibility to CD.
He had debut of epilepsy 11 years old, with simple and complex partial seizures with visual disturbances and anxiety as main ictal symptoms. His seizures turned out to be drug resistant, and 30 years old he underwent presurgical evaluation.
RESULTS: Cerebral CT revealed unilateral right parieto-occipital calcifications without enhancement after injection of contrast. Interictal EEG revealed more or less continuous bilateral synchronous spike-wave activity in both parieto-occipital regions, with possible maximum on the right side. Ictal EEG-recordings with intracranial strip electrodes confirmed seizure onset in the right occipital area.
When he was 31 years old he had epilepsy surgery. Under corticographic guiding the cortical area with the demonstrated calcifications in the right parieto-occipital lobe was removed. Since then he has been completely seizure-free. He has a modest left-sided quadrant anopsy. He is now fully employed and is in the leisure time participating in long distance bicycle-, running-, and ski competitions.
CONCLUSIONS: In patients with CD, drug resistant epilepsy, and intracranial calcifications, epilepsy surgery should be considered as lesionectomy may be very successful.
Support: No fundings