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Demonstrates refractory complex partial seizures from multiple cerebral cavernous malformations, highlighting diagnostic challenges following prior incomplete resection.
A 40-year-old man presented for management of seizures. His first seizure was 5 years earlier. Evaluation at that time revealed a hemorrhagic lesion near the occipital horn of the left lateral ventricle. Incomplete surgical excision was performed with indeterminate pathology suggestive of an astrocytoma. MRI demonstrated 7 separate lesions consistent with cavernous malformations. One measured 1.5 cm in diameter with T2 heterogeneous signal surrounded by a rim of low signal in the medial left temporal lobe. His current seizures have a complex partial semiology and occur 2-4 times per month despite treatment with 2 antiepileptic drugs (AEDs).
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Chahine et al. (2009) studied this question.
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