Hatano Keisuke, Fujimoto Ayataka, Inenaga Chikanori, Otsuki Yoshiro, Enoki Hideo, Okanishi Tohru
Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu, Shizuoka 430-8558, Japan.
Department of Neurosurgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu, Shizuoka 430-8558, Japan.
Brain Sci. 2021 Aug 27;11(9):1136. doi: 10.3390/brainsci11091136.
Intracranial dermoid cyst is a rare, benign, nonneoplastic tumor-like lesion that could cause seizures, headache, and hydrocephalus. We hypothesized that the temporal lobe dermoid cyst in combination with other factors were causing the epileptic seizure.
We encountered a 17-year-old girl with anti-seizure medication-resistant epilepsy secondary to dermoid cyst located in the temporal region depicted on magnetic resonance imaging (MRI). She showed neither symptoms of meningitis nor rupture of the cyst according to serial MRI. We hypothesized that temporal lobe dermoid cyst in combination with other factors, such as focal cortical dysplasia (FCD), etc., was causing epileptic seizures in this case. She underwent dermoid cyst removal surgery with resection of the tip of the antero-inferior temporal lobe.
Histopathological study showed multiple small intramedullary dermoid cysts in the left antero-inferior temporal lobe in addition to MRI lesions and FCD.
A patient with medically intractable epilepsy secondary to left temporal lobe dermoid cyst showed multiple intramedullary dermoid cysts and focal cortical dysplasia that might have interacted to create epileptogenicity. To our knowledge, this is the first case report of dermoid cyst concomitant with FCD.
颅内皮样囊肿是一种罕见的、良性的、非肿瘤性肿瘤样病变，可导致癫痫发作、头痛和脑积水。我们推测颞叶皮样囊肿与其他因素共同导致了癫痫发作。
我们遇到一名17岁女孩，患有对抗癫痫药物耐药的癫痫，其病因是磁共振成像（MRI）显示位于颞区的皮样囊肿。根据连续的MRI检查，她既没有脑膜炎症状，囊肿也未破裂。我们推测在该病例中，颞叶皮样囊肿与其他因素，如局灶性皮质发育不良（FCD）等共同导致了癫痫发作。她接受了皮样囊肿切除手术，并切除了颞叶前下部尖端。
组织病理学研究显示，除了MRI显示的病变和FCD外，左颞叶前下部还有多个小的髓内皮样囊肿。
一名继发于左颞叶皮样囊肿的药物难治性癫痫患者显示出多个髓内皮样囊肿和局灶性皮质发育不良，它们可能相互作用产生了致痫性。据我们所知，这是首例皮样囊肿合并FCD的病例报告。
