Tumor arising in the periventricular region

A 32-year-old immunocompetent female patient, 8 months pregnant, underwent three complex partial seizures beginning with visual hallucinations and secondarily generalized.She had been in good health until then.The pregnancy was normal and no high blood pressure was noted.Clinical examination revealed a left nystagmus, a right sensory hemibody deficiency and a right pyramidal syndrome.MRI showed an isolated intraparenchymal lesion in the left parieto-occipital region with an enhancement of the left lateral ventricle floor (Fig. 1a,b).The biological assessments, including hemogram, ionogram, CRP, liver enzymes and b2 microglobulin, were all normal.An elevated erythrocyte sedimentation rate was noted.CMV, HBV, HCV, and Lyme serologies were negative.Previous HSV, EBV, and varicella zoster virus infection markers were found.CSF examination revealed hyperproteinorachia (0.95 g/L) without cellular reaction.No tumoral cells were found.Thoracic and abdominal CT was normal.After the brain biopsy, a course of corticosteroids was started.The patient did not present with any other seizures.Five years after the first epileptic manifestations, follow-up MRI demonstrated resolution of the enhancing lesions (Fig. 2) and the patient was in good health with 10 mg of corticosteroids daily.