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< BACK TO CLINICAL BREAKTHROUGHS IN NEUROSCIENCES

July 2023

NEUROSCIENCES

CASE CHALLENGE: A 51-YEAR-OLD WITH NEW ONSET SEIZURES

A 51-year-old previously healthy man noticed transient numbness and tingling in his left arm. A few days later, he experienced a 10-second episode of left arm flailing, along with a feeling of being “disconnected” lasting approximately 10-20 seconds. Immediately before this episode, the patient experienced lightheadedness, flushing and a feeling of dread.
 
Upon examination, the care team found that the patient had diminished sensation to temperature in his right leg. A Brain MRI revealed a 1.4-by-1.5-centimeter right superior frontal gyrus lesion. The lesion was hyperintense on fluid-attenuated inversion recovery (FLAIR) imaging (Figure 1), and it was not associated with any enhancement (Figure 2).
 
What’s the diagnosis?
Figure 1. Axial fluid-attenuated inversion recovery (FLAIR) MRI demonstrates hyperintensity of lesion.
Figure 2. Axial T1 post-gadolinium MRI shows no contrast enhancement.
Solve the case published in Practical Neurology >

​Reproduced with permission from Ansali B, Tate M, Templer JW, Dixit K: Challenge Case Report: New Onset Seizures. Practical Neurology (US) 2021;20(9):58-62.
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Matthew C. Tate, MD, PhD, is an associate professor of Neurological Surgery and Neurology at Northwestern Medicine.
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Jessica W. Templer, MD, is an assistant professor of Neurology in the Division of Epilepsy/Clinical Neurophysiology at Northwestern Medicine.
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Karan S. Dixit, MD, is an assistant professor of Neurology in the Divisions of Neuro-oncology and Hospital Neurology at Northwestern Medicine.

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  • Home
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