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Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report

Behçet’s disease (BD) is a rare chronic inflammatory disease associated with systemic vasculitis. Involvement of the nervous system in BD is called neuro-BD (NBD). Epilepsy related to NBD is uncommon but responds well to anti-epileptic drugs. We present a case of NBD with drug-resistant mesial tempo...

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Autores principales: IWAMOTO, Hirofumi, HANAYA, Ryosuke, BRILLIANTIKA, Surya Pratama, SATO, Masanori, HOSOYAMA, Hiroshi, OTSUBO, Toshiaki, UMEHARA, Fujio, YOSHIMOTO, Koji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769486/
https://www.ncbi.nlm.nih.gov/pubmed/35079496
http://dx.doi.org/10.2176/nmccrj.cr.2020-0218
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author IWAMOTO, Hirofumi
HANAYA, Ryosuke
BRILLIANTIKA, Surya Pratama
SATO, Masanori
HOSOYAMA, Hiroshi
OTSUBO, Toshiaki
UMEHARA, Fujio
YOSHIMOTO, Koji
author_facet IWAMOTO, Hirofumi
HANAYA, Ryosuke
BRILLIANTIKA, Surya Pratama
SATO, Masanori
HOSOYAMA, Hiroshi
OTSUBO, Toshiaki
UMEHARA, Fujio
YOSHIMOTO, Koji
author_sort IWAMOTO, Hirofumi
collection PubMed
description Behçet’s disease (BD) is a rare chronic inflammatory disease associated with systemic vasculitis. Involvement of the nervous system in BD is called neuro-BD (NBD). Epilepsy related to NBD is uncommon but responds well to anti-epileptic drugs. We present a case of NBD with drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). The patient presented with headache, dizziness, disorientation, and generalized seizures. Magnetic resonance imaging (MRI) identified pontine lesions. Chronic inflammation was suspected, and steroid pulse therapy improved his symptoms. He relapsed 1 year after onset and was diagnosed with NBD. MRI revealed bilateral mesial temporal lesions, with the right being edematous and the left atrophic. NBD was controlled by steroid and immunosuppressive medication. Three years after the onset of NBD, the patient suffered MTLE, and MRI suggested left hippocampal atrophy. His seizures became drug-resistant and surgical therapy was considered 12 years after NBD onset. Pre-surgical MRI clearly showed left HS. After evaluations, the patient had left anterior temporal lobectomy (ATL) 13 years after NBD onset under stable NBD. The patient was seizure-free for > 2 years after surgery. Surgery will be an effective treatment for drug-resistant MTLE with HS even in patients with NBD, of course the effects of surgical intervention should be considered.
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spelling pubmed-87694862022-01-24 Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report IWAMOTO, Hirofumi HANAYA, Ryosuke BRILLIANTIKA, Surya Pratama SATO, Masanori HOSOYAMA, Hiroshi OTSUBO, Toshiaki UMEHARA, Fujio YOSHIMOTO, Koji NMC Case Rep J Case Report Behçet’s disease (BD) is a rare chronic inflammatory disease associated with systemic vasculitis. Involvement of the nervous system in BD is called neuro-BD (NBD). Epilepsy related to NBD is uncommon but responds well to anti-epileptic drugs. We present a case of NBD with drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). The patient presented with headache, dizziness, disorientation, and generalized seizures. Magnetic resonance imaging (MRI) identified pontine lesions. Chronic inflammation was suspected, and steroid pulse therapy improved his symptoms. He relapsed 1 year after onset and was diagnosed with NBD. MRI revealed bilateral mesial temporal lesions, with the right being edematous and the left atrophic. NBD was controlled by steroid and immunosuppressive medication. Three years after the onset of NBD, the patient suffered MTLE, and MRI suggested left hippocampal atrophy. His seizures became drug-resistant and surgical therapy was considered 12 years after NBD onset. Pre-surgical MRI clearly showed left HS. After evaluations, the patient had left anterior temporal lobectomy (ATL) 13 years after NBD onset under stable NBD. The patient was seizure-free for > 2 years after surgery. Surgery will be an effective treatment for drug-resistant MTLE with HS even in patients with NBD, of course the effects of surgical intervention should be considered. The Japan Neurosurgical Society 2021-08-07 /pmc/articles/PMC8769486/ /pubmed/35079496 http://dx.doi.org/10.2176/nmccrj.cr.2020-0218 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Report
IWAMOTO, Hirofumi
HANAYA, Ryosuke
BRILLIANTIKA, Surya Pratama
SATO, Masanori
HOSOYAMA, Hiroshi
OTSUBO, Toshiaki
UMEHARA, Fujio
YOSHIMOTO, Koji
Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title_full Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title_fullStr Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title_full_unstemmed Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title_short Surgical Treatment for Mesial Temporal Lobe Epilepsy Accompanied with Neuro-Behçet’s Disease: A Case Report
title_sort surgical treatment for mesial temporal lobe epilepsy accompanied with neuro-behçet’s disease: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769486/
https://www.ncbi.nlm.nih.gov/pubmed/35079496
http://dx.doi.org/10.2176/nmccrj.cr.2020-0218
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