Successful surgical outcome in a patient with coexistence of focal epilepsy due to DNET and Jeavons Syndrome
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The coexistence of symptomatic and idiopathic epilepsy has rarely been described and may pose diagnostic and therapeutic challenges. We herein describe a patient with focal epilepsy due to dysembryoblastic neuro-epithelial tumors (DNET) associated with Jeavons Syndrome, who underwent successful lesionectomy. At the age of 13 years, this boy presented rare generalized tonicclonic seizures controlled by valproic acid. Two years later, dyscognitive focal seizures occurred. Eyelid myoclonia with or without absences (EMA) occurring after eye-closure, photoparoxysmal response and focal seizures arising from left temporal lobe were recorded by video-EEG. Brain MRI revealed a left temporal DNET. The combination of different antiepileptic drugs gave no benefit. Due to drug-resistant disabling temporal lobe seizures, patient underwent lesionectomy. At 33-month follow-up, patient was free from temporal lobe seizures. Notably, despite the persistence of EMA, patient’s quality of life greatly improved. This report highlights the importance to consider surgery even in patients with coexistence of both symptomatic and idiopathic epilepsies.e.
KEY WORDS: epilepsy surgery, double pathology, eyelid myoclonia, photosensitivity, quality of lif