pyramidal syndrome characterized by incomplete hemiparesis on the right hemibody. Myotatic exalted reflexes in the right hemibody and plantar-cutaneous reflex were indifferent.
DiSCuSSionReviewing the relevant literature worldwide, Labrune syndrome was considered as a possible diagnosis for the present case 2 . Despite the presence of cysts, calcification, and edema of the white substance found in our patient, suggesting neurocysticercosis, equinecocosis 3 or neoplasia, there was no serologic or histopathologic confirmation.This syndrome is characterized by calcifications, leukodystrophy, and formation of parenchymal cysts 1 . Its onset can occur during childhood or adolescence, in an average of 12 years (7 months -59 years), but there was not one in adults in Brazil, with neurological signs such as cognitive decline, seizures and pyramidal, extrapyramidal or cerebellar signs 1,2 . Our patient, unlike the other cases reported in literature, presented its first neurological manifestation at the age of 24. CT and MRI seen in our case were similar to the cases reported in literature, showing increased signal intensity of the white matter on MRI (T2 and FLAIR), basal ganglia calcification, and development of cysts [1][2][3] .Labrune reported the results of histopathology with rearrangement involving the microvessels, whereas perivascular foci of calcifications, hyaline deposits, and formation of Rosenthal fibers seem to be compatible with this change 1 . The histopathological findings of our patient were consistent with LCC. According to them, the likely primary pathologic feature is a rearrangement involving the microvessels and the formation of Rosenthal fibers 1,4 .In conclusion, the etiology of LCC remains unknown. In spite of relatively characteristic findings in imaging and histopathological examination, there is no uniformity in the clinical findings noted in the published articles. It can be speculated that the later age of onset, normal intelligence and slow progression, like in our patient, may indicate the shape of this rare disease in adults. A 33-year-old woman (registration 70-247/ IPUB-UFRJ) has had recurring headaches since the age of 18. She described more right-sided than left-sided throbbing, which could be severe and associated with nausea, light and noise sensitivity, and vomiting. She has had a visual aura, seeing "zig-zags", lasting for 20 to 30 minutes before the headaches. The only preventive measure she had taken in the past was divalproex sodium, with good efficacy. Because of the weight gain as a side effect, she refused to take it again. Her body mass index (BMI) was 35.3. She was started on preventive therapy with topiramate at 25 mg daily for two weeks that was to be increased weekly