21254744 Visualization

A 27 Age years Age old Age , male Sex , right History handed History , was admitted Clinical_event for a 2 Duration years Duration history of very Detailed_description frequent Detailed_description gelastic Disease_disorder seizures Disease_disorder .
The patient described aura Sign_symptom – like Sign_symptom symptoms Sign_symptom : especially warmth Sign_symptom throughout the face Biological_structure and dizziness Sign_symptom that preceded the seizure Sign_symptom and he denied any affective Sign_symptom connotation Sign_symptom .
Some Detailed_description of the seizures Sign_symptom consisted only of a brief Detailed_description period of laughter Sign_symptom without any motor Sign_symptom involvement Sign_symptom , but a typical seizure Sign_symptom would consist of sudden Detailed_description laughter Sign_symptom accompanied by simple Sign_symptom motor Sign_symptom partial Sign_symptom seizures Sign_symptom in both Biological_structure arms Biological_structure , more often being involved his left Biological_structure arm Biological_structure , without impairment Sign_symptom of Sign_symptom his Sign_symptom consciousness Sign_symptom state Sign_symptom , which lasted less Detailed_description than Detailed_description 1 Detailed_description minute Detailed_description .
He had no History previous History past History medical History or History social History history History other than being a smoker History : 10–15 cigarettes Quantitative_concept per Quantitative_concept day Quantitative_concept .
The frequency of the seizures Sign_symptom was initially Detailed_description low Frequency , but increased Detailed_description progressively Detailed_description over Detailed_description time Detailed_description to about 8–10 seizures/day Frequency , despite anti Therapeutic_procedure – epileptic Therapeutic_procedure treatment Therapeutic_procedure – at the time of admission Clinical_event he was taking Keppra Medication – Levetiracetam Medication 3 Dosage x Dosage 250 Dosage mg/day Dosage and Phenytoin Medication 3 Dosage x Dosage 100 Dosage mg/day Dosage .
With the Neurology Nonbiological_location Electrophysiology Nonbiological_location Department Nonbiological_location assistance Clinical_event we have been able to record a couple of seizures Sign_symptom on the Video Diagnostic_procedure – EEG Diagnostic_procedure His neurological Diagnostic_procedure examination Diagnostic_procedure was normal Lab_value .
Diagnosis was made on native Detailed_description CT Diagnostic_procedure scan Diagnostic_procedure : minimal Detailed_description hypodense Detailed_description frontal Biological_structure right Biological_structure paramedian Biological_structure lesion Sign_symptom (Figure 1A), cerebral Biological_structure MRI Diagnostic_procedure (Figure 1 B–F) showed a small Detailed_description right Detailed_description parenchymal Detailed_description homogeneous Detailed_description lesion Sign_symptom 16/22/15mm Volume , well Detailed_description delimited Detailed_description , involving gyrus Biological_structure cinguli Biological_structure , without perilesional Detailed_description edema Sign_symptom and mass Sign_symptom effect Sign_symptom , hyperintense Detailed_description both Detailed_description on Detailed_description T1 Detailed_description and Detailed_description T2 Detailed_description MR Detailed_description sequences Detailed_description , non Detailed_description – enhancing Detailed_description after Detailed_description Gadolinium Detailed_description .
The cerebral Biological_structure lesion Sign_symptom was also documented on EEG Diagnostic_procedure and video Diagnostic_procedure – EEG Diagnostic_procedure recordings: 3 Lab_value seizures Sign_symptom with medio Detailed_description – frontal Detailed_description origin Detailed_description and rare Detailed_description interictal Detailed_description epileptiform Detailed_description elements Detailed_description were recorded (Figure 1I)
Using an interhemispheric Biological_structure microsurgical Therapeutic_procedure approach Therapeutic_procedure , above Biological_structure the Biological_structure corpus Biological_structure callosum Biological_structure and the right Biological_structure pericallosal Biological_structure artery Biological_structure , at the level of gyrus Biological_structure cinguli Biological_structure , a yellow Color – gray Color , infiltrative Detailed_description tumour Sign_symptom , having a moderate Severity vascularisation Detailed_description had been identified and totally removed Therapeutic_procedure .
The anatomo Diagnostic_procedure – pathological Diagnostic_procedure analysis Diagnostic_procedure revealed a grade Lab_value Ⅱ Lab_value astrocytoma Disease_disorder .
The patient recovered Sign_symptom very well, without deficits Sign_symptom , no gelastic Disease_disorder seizures Disease_disorder or epileptic Sign_symptom manifestations Sign_symptom ; three Date months Date after Date operation Date he is still free of seizures Sign_symptom .
A control postop CT Diagnostic_procedure revealed no tumor Sign_symptom (1 G, H)