Gangliocytoma, a surgically treatable cause of drug resistant early onset partial epilepsy

Paciente de 20 anos de idade apresentava crises parciais simples sensitivo-motoras com início na perna direita desde os 4 anos. As crises ocorriam pelo menos uma vez por semana e eram refratárias a drogas antiepilépticas. Crises secundariamente generalizadas eram infrequentes. EEGs interictais mostravam espículas centro-parietais máximas na linha média. EEGs letais registraram atividade teta rítmica nas regiões parasagitais, sem lateralização. Ressonãncia magnética mostrou uma lesão na porção medial do lobo parietal esquerdo, isointensa ao córtex em imagens ponderadas em T1 e hiperintensa em imagens T2. Foi realizada a ressecção cirúrgica completa da lesão, guiada por eletrocorticografia. Histopatologia demonstrou um gangliocitoma, uma causa pouco frequente, cirurgicamente tratável, de epilepsia parcial resistente ao tratamento medicamentoso

Recurrent abdominal pain: when an epileptic seizure should be suspected?

Recurrent episodes of abdominal pain are common in childhood. Among the diagnostic possibilities are migraine and abdominal epilepsy (AE). AE is an infrequent syndrome with paroxystic episodes of abdominal pain, awareness disturbance, EEG abnormalities and positive results with the introduction of antiepileptic drugs. We present one 6 year-old girl who had short episodes of abdominal pain since the age of 4. The pain was followed by cry, fear and occasionally secondary generalization. MRI showed tumor in the left temporal region. As a differential diagnosis, we report a 10 year-old boy who had long episodes of abdominal pain accompanied by blurring of vision, vertigo, gait ataxia, dysarthria, acroparesthesias and vomiting. He received the diagnosis of basilar migraine. In our opinion, AE is part of a large group (partial epilepsies) and does not require a special classification. Pediatric neurologists must be aware of these two entities that may cause abdominal pain