Diencephalic epilepsy with congenital suprasellar arachnoid cyst in an infant

Abstract

The authors report the case of a 2-year-old infant who presented with paroxysm and short changes characterized by acute drowsiness, cold sweats, ocular reversion, facial cyanosis, and bradycardia. Between these attacks, the condition was normal, suggesting diencephalic seizures. Over 2 months five fits were observed by the parents when some to-and-fro bobbing of the head onto the trunk appeared during drowsiness. One electroencephalogram was normal without a slow background or spikes discharges. As the skull radiographs showed erosion of the jugum and chronic intracranial hypertension features, a CT scan was performed and showed hydrocephalus associated with a congenital suprasellar cyst. The cyst was opened into basal cisterns with cystoperitoneal shunt. The histological examination revealed that it was an arachnoid cyst. Six months later, the infant was free of diencephalic seizures and head bobbing. Thus, we can assert that there was a direct relationship between this cyst and the diencephalic seizures. From this case, the authors make a review of the clinical features of diencephalic epilepsy, and their different causes and show that both diencephalic epilepsy and suprasellar arachnoid cysts are not common.

Yawning in Diseases

“…Salvos of yawning and irrepressible hiccupping accompany this spectacular and very unpleasant profile. The cases described reveal the presence of thalamic tumors [88,89,90,91,92]. D’Mello et al [93] also report salvos of yawns as an iatrogenic effect of vibratory massage or of the withdrawal of neuroleptics, persisting several months after convulsions are provoked.…”

Bromocriptine for Control of Hyperthermia in a Patient with Mixed Autonomic Hyperactivity after Neurosurgery: A Case Report

“…However, many authors have described the autonomic hyperactivity as consistent with the sympathetic division alone (2, 3). Lately, cases of PAH have been separated into two categories: those consisting of paroxysmal sympathetic hyperactivity in the absence of parasympathetic features and those involving a combination of sympathetic and parasympathetic hyperactivity, termed mixed autonomic hyperactivity disorders (MAHD) (4, 5). MAHD is clinically diagnosed based on the combined presence of sympathetic hyperactivity (increased heart rate (HR), respiratory rate (RR), blood pressure (BP) and body temperature (BT), sweating and papillary dilatation) and parasympathetic hyperactivity (decreased HR, RR, BP and BT, piloerection, flushing, papillary contraction, hiccups, lacrimation, yawning, and sighing) (6).…”

Associated Diseases

“…Salvos of yawning and irrepressible hiccupping accompany this spectacular and very unpleasant profile. The cases described reveal the presence of thalamic tumors [83][84][85][86][87]. D'Mello et al [88] also reported salvos of yawns as an iatrogenic effect of vibratory massage or of the withdrawal of neuroleptics, persisting several months after convulsions are provoked.…”