Temporal lobe seizures from a posterior cerebral artery aneurysm presenting as memory flashbacks

Abstract

Memory flashbacks are usually attributed to recreational drugs or psychiatric conditions. The differential diagnosis for memory flashbacks is diverse and challenging; moreover, management is influenced by the working diagnosis. We describe the case of a 35-year-old man who presented with memory flashbacks secondary to temporal lobe seizures from an unruptured aneurysm of the posterior cerebral artery. To our knowledge, a case of this nature has not been previously reported. This case demonstrates the need to recognize that, on rare occasions, a complaint of memory flashbacks can be the result of an organic etiology. We also discuss the challenging presentations of temporal lobe seizures, as they can easily be misdiagnosed as a psychiatric condition.

Unruptured Posterior Cerebral Artery Aneurysm Presenting with Temporal Lobe Epilepsy

“…Notably, seizure onset was focal in four cases. [7][8][9][10] Of these, awareness was described in two patients as being impaired and in one patient as intact.…”

“…A review of the literature identified five cases of patients with PCA aneurysms presenting with seizures (Table 1). [6][7][8][9][10] The median age was 30, with range between 7 weeks to 35 years. Unique to the present case, the patient is the oldest reported at 59 years of age.…”

“…Two of the five cases identified in the literature underwent endovascular treatment of their aneurysms. 8,10 Posterior circulation aneurysms are often treated with an endovascular approach due to the challenging surgical exposure and the close proximity of other deep brain structures. Notably, outcomes in these cases were largely comparable to those treated with surgery, with no described follow-up morbidity or mortality in either group.…”