We report a 47-year-old man who presented with partial seizures complicating focal cerebral vasculitis of the right temporal lobe. Excisional biopsy of the mass lesion revealed fibrinoid necrosis of small vessels. These vessels were infiltrated by neutrophils, eosinophils, lymphocytes, and plasma cells. Despite extensive evaluation, no etiology was apparent for the vasculitis. No immunosuppressive agents were administered, and 4 1/2 years after the diagnosis, he remains healthy except for an incongruous left homonymous hemianopia. Follow-up cranial magnetic resonance images revealed only postoperative changes. This case demonstrates that focal lesions and a benign course may represent one end of the spectrum of primary angiitis of the central nervous system.

We report on a woman with idiopathic Meige's syndrome whose dystonia improved with the use of levetiracetam (LEV, Keppra, UCB Pharma, Smyrna, GA). This report and data from an animal model of paroxysmal dystonia suggest that LEV might be helpful in the treatment of dystonia.

We discuss five patients who had cerebral air embolisms. Clinically, these patients had early seizures, focal neurological findings, or failure to awaken from anesthesia. The patients that survived had minimal neurological deficits. We also discuss the pathophysiology of cerebral air embolism and its differentiation from "the bends." The necessity for recognizing this entity early is important in order to administer appropriate therapy.

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