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KMID : 0377819830030040085
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Diagnosis and Treatment
1983 Volume.3 No. 4 p.85 ~ p.93
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高昌俊
徐延鎬
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Abstract
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From Jan. 1980 to 1983, 616 epileptic patients were clinically analazied at pediatric depart of Yonsei medical school.
271 Out of 646 patients had computerized tomography and disclosed various pathologic findings.
Granulomatous lesions were detected in 6 cases, which have interesting clinical features, that also disappeared :spontaneously without specific treatment.
By reviewing patients, we are able to collect 52 cases of epileptics with granulomatous lesion in their computerized tomography. The clinical features and follow up study of those patients has following clinical characteristics.
1) The granulomatous lesion in C -T scan disclosed ring form or round, coin like lesion with enhancement associated with some irregular decreased densities around the lesion.
2) The nature of the lesion is not identified; pathological study of the biopsied material disclosed none specific inflammation. No other evidence of infection is detected.
3) The epileptics with this granuloma have no focal neurologic sign or symptom except the seizure.
4) It is common in epileptic patients between 5 and 15 years of age, but it may occure in any age.
5) It is most commonly founded in parietal lobe, but it may occure any part of brain as well as in multi area.
6) The clincal type of seizure in these patient is most commonly focal seizure as well as generalized epilepties.
7) The EEG of these patients disclosed triphasic or spike activity with phase reveral as well as localized slow waves.
8) Without specific treatment except the anticovulsant, the granuloma disappeared or calcified, most of them decreased in size during the various period of times.
9) By reviwing the literatures, no these lesion is ever reported.
10) As this lesion disappeared spontaneouly, it would be better to pospond the possible unnecessary neurosurgival intervetion for a few month with periodic close observation.
11) As the number of patients are small and observation period is not long enough, more intimate clinical investigstion with larger number of patients to clearfied the whole nature of this granulomatous lesion of this epiletic patients is required.
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KEYWORD
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