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Letter to the Editor| Volume 352, ISSUE 1-2, P112-114, May 15, 2015

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Delayed diagnosis of vestibular epilepsy due to temporal cavernous malformation

  • Sun-Uk Lee
    Affiliations
    Department of Neurology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
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  • Chang-Ho Yun
    Affiliations
    Department of Neurology, Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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  • Ji-Soo Kim
    Correspondence
    Corresponding author at: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. Tel.: +82 31 787 7463; fax: +82 31 719 6828.
    Affiliations
    Department of Neurology, Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
    Search for articles by this author
Published:March 21, 2015DOI:https://doi.org/10.1016/j.jns.2015.03.021
      Vestibular epilepsy refers to recurrent seizures that cause dizziness/vertigo as a sole or predominant symptom [
      • Brandt T.
      Vestibular epilepsy. Vertigo: its multisensory syndromes.
      ]. It is due to epileptic discharges from the vestibular cortices mostly residing in the temporal [
      • Kogeorgos J.
      • Scott D.F.
      • Swash M.
      Epileptic dizziness.
      ] or temporo-parietal areas [
      • Altay E.E.
      • Serdaroglu A.
      • Gucuyener K.
      • Bilir E.
      • Karabacak N.
      • Thio L.
      Rotational vestibular epilepsy from the temporo-parieto-occipital junction.
      ,
      • Hewett R.
      • Guye M.
      • Gavaret M.
      • Bartolomei F.
      Benign temporo-parieto-occipital junction epilepsy with vestibular disturbance: an underrecognized form of epilepsy?.
      ,
      • Lee S.U.
      • Suh H.I.
      • Choi J.Y.
      • Huh K.
      • Kim H.J.
      • Kim J.S.
      Epileptic nystagmus: a case report and systematic review.
      ] but also in the frontal cortex [
      • Kluge M.
      • Beyenburg S.
      • Fernández G.
      • Elger C.E.
      Epileptic vertigo: evidence for vestibular representation in human frontal cortex.
      ]. Cerebral cavernous malformations, an enlarged collection of vascular channels invading adjacent brain tissue, mostly present with recurrent seizures in the supratentorial areas. Vestibular epilepsy has been reported in oligodendroglioma [
      • Lopez C.
      • Heydrich L.
      • Seeck M.
      • Blanke O.
      Abnormal self-location and vestibular vertigo in a patient with right frontal lobe epilepsy.
      ] and astrocytoma [
      • Kluge M.
      • Beyenburg S.
      • Fernández G.
      • Elger C.E.
      Epileptic vertigo: evidence for vestibular representation in human frontal cortex.
      ], but has not been described in association with a cavernous malformation. Herein, we describe a patient with recurrent spontaneous vertigo from a small temporal cavernous malformation that had escaped detection for several years.
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