The present study describes the case of a 27-year-old, right-handed female with bilateral mesial temporal lobe epilepsy. Electroencephalogram (EEG) monitoring from implanted electrodes displayed two different and independent onsets on the two sides of the mesial temporal structures, which specifically included clinical generalized tonic clonic seizure (GTCS) discharges originating from the left mesial temporal lobe, as well as complex partial seizure (CPS) discharges arising from the right mesial region. However, fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) showed a unilateral abnormality, as in right mesial temporal lobe sclerosis. A decision was made to resect one side of the mesial temporal lobe, in order to avoid memory function impairment, and, relying on the MRI results, the right side was selected. However, surgery did not leave the patient seizure-free. The CPSs gradually eased, while the GTCSs originating from the left side became severely aggravated. In describing this case, the drawbacks of current epileptic diagnostic methods and surgical strategies for bitemporal lobe epilepsy are discussed, and the requirement for more treatment options is emphasized.

Aim: Meningeal carcinomatosis is a special type of malignant tumor characterized by short survival and poor prognosis. In the present study, the authors aim to analyze the clinical, laboratory data and prognosis of meningeal carcinomatosis patients. Methods: The authors enrolled 77 cases of meningeal carcinomatosis from 2003 to 2013 in the First Hospital of Jilin University. The clinical data including age, gender, symptoms at onset, clinical manifestations, primary tumors and the laboratory data including cerebrospinal fluid (CSF), tumor markers as well as the imaging data were analyzed. The interval between the onset of primary tumor and the onset of central nervous symptoms, treatments and survival time were also analyzed. Results: The onset of meningeal carcinomatosis was usually acute (46.2%) or subacute (39.0%). The most frequent symptom at onset was intracranial hypertension (70.1%). Symptoms such as headache, vomit and high lumbar puncture intracranial pressure was observed in 56% of cases during the course of the disease. CSF abnormalities such as higher protein concentration (73.4%), more CSF pleocitosis (57.1%) and lower glucose levels (48.4%) were found in 95.3% of meningeal carcinomatosis patients. Non-contrast enhanced cerebral magnetic resonance imaging (MRI) showed that 13.2% patients had abnormal meningeal changes while in the enhancement scan 35.3% patients showed changes. The serum tumor markers increased in 84% of the patients. There were no differences regarding the mean survival between patients who received intrathecal chemotherapy and those who received brain radiotherapy or supportive treatment. Conclusion: The most common clinical manifestation of meningeal carcinomatosis is intracranial hypertension. The most common primary tumor is lung cancer, followed by gastric cancer and breast cancer. The linear enhancement of meningeal on the MRI scan is of great importance for the diagnosis of meningeal carcinomatosis. Key words:Meningeal carcinomatosis, cerebrospinal fluid, magnetic resonance imaging, therapy ABSTRACTArticle history: