Kozo Tashima1*, Tatsuya Tanaka1,2, Takeshi Tonegawa1, Akihito Hashiguchi1, Koichi Moroki1 and Hajime Tokuda1
1Department of Neurosurgery, Tokuda Neurosurgery Hospital, Japan
2Department of Neurosurgery, Asahikawa Medical College, Japan
This case involves a 15-year-old girl who had first experienced brief attacks of impaired consciousness when she was 14 years old. Subsequently, frequent occurrence of similar seizures accompanied with occasional foot stomping caused her to visit our hospital. Although there were no abnormal neurological findings, head computed tomography and magnetic resonance imaging revealed a 50 mm × 35 mm × 35 mm intracranial tumor deep in the interhemispheric fissures of the bilateral frontal lobe. The initial Electroencephalogram (EEG) did not show any apparent epileptic spikes, but High-Frequency Oscillation (HFO, 80 Hz) was frequently observed, mainly in the bilateral fronto-parietal lobes. Frequent unconscious fits with occasional foot stomping were observed; therefore, we diagnosed her with frontal lobe epilepsy. She was started on levetiracetam 1000 mg/ day, and the clinical seizure was well controlled. Since surgical removal of the large tumor of our case may cause blood flow damage in the posterior half of the interhemispheric fissure, conservative treatment was indicated. Although there are previous reports of lipomas in the corpus callosum, there are no reports of epilepsy cases with HFO recordings until now. However, rich vascularization of the large corpus callosum lipoma cannot neglect the future risk of tumor enlargement, malignant transformation or seizure recurrence, periodic follow up is indicated for further work up including hospitalization for possible surgical indication. We report a case of large corpus callosum lipoma in which HFO was useful to diagnose frontal lobe epilepsy.
Tashima K, Tanaka T, Tonegawa T, Hashiguchi A, Moroki K, Tokuda H. High-Frequency Oscillations Led to the Diagnosis of Frontal Lobe Epilepsy in a Case of Large Corpus Callosum Lipoma: A Case Report. Clin Surg. 2022; 7: 3454..