Ovalle Torres Carlos Salvador, Efe Ibrahim E, Ramirez Manuel de Jesus Encarnacion, Diaz Juarez Eduardo, Ruano Calderon Angel, Nurmukhametov Renat, Campero Alvaro, Ramirez Pena Issael Jesus, Montemurro Nicola
Neurosurgery, National Autonomous University of Mexico, General Hospital, Mexico, MEX.
Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, DEU.
Cureus. 2023 Sep 16;15(9):e45360. doi: 10.7759/cureus.45360. eCollection 2023 Sep.
Epidermoid cysts represent roughly 1% of all intracranial tumors. They are frequently located in the cerebellopontine angle but rarely extend to the supratentorial brain. Epilepsy is an extremely uncommon manifestation of this neoplasm. We suggest the surgical management of a 35-year-old male who presented with a six-month history of intractable temporal lobe epilepsy. His seizures were characterized by a focal onset in the form of déjà vu experiences, followed by a secondarily generalized tonic-clonic seizure. Imaging revealed a heterogeneous cystic mass in the right cerebellopontine angle, extending supratentorially causing a mass effect on the mesial temporal region. Gross total resection was achieved through a combined subtemporal-retrosigmoid approach. Histopathology revealed an epidermoid cyst. The patient was entirely seizure-free at the three-month follow-up. Epidermoid cysts may present with epileptic seizures. Seizure freedom can be achieved with surgical management in most cases. The patient's symptoms, imaging findings, and epileptogenic focus must be considered to select the appropriate surgical strategy.
表皮样囊肿约占所有颅内肿瘤的1%。它们常位于桥小脑角，但很少延伸至幕上脑区。癫痫是这种肿瘤极其罕见的表现形式。我们报告一名35岁男性的手术治疗情况，该患者有6个月的顽固性颞叶癫痫病史。其癫痫发作的特点是局灶性发作，表现为似曾相识感，随后继发全面性强直阵挛发作。影像学检查显示右侧桥小脑角有一个异质性囊性肿块，向上延伸至幕上，对颞叶内侧区域产生占位效应。通过颞下-乙状窦后联合入路实现了肿瘤全切。组织病理学检查显示为表皮样囊肿。在3个月的随访中，患者癫痫完全缓解。表皮样囊肿可能表现为癫痫发作。大多数情况下，手术治疗可实现癫痫缓解。选择合适的手术策略时必须考虑患者的症状、影像学表现和癫痫病灶。
