Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | Journal of epilepsy and clinical neurophysiology (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000700007 |
Resumo: | INTRODUCTION: Generalized tonic-clonic seizures (GTCS) are among the most dramatic types of epileptic seizures and may be accompanied by rising blood pressure and pulse rate, physical injuries from falling, muscular convulsions, tongue biting, or aspiration pneumonia. Epistaxis is an uncommon complication of generalized seizures and investigations should exclude local or systemic disorders. OBJECTIVE: We aim to report a 29-year-old male patient with medically intractable right temporal lobe epilepsy whose ictal SPECT showed a conspicuous high extracerebral accumulation of the tracer at the skull base. METHODS: The tracer 99mTc-ECD was injected during a GTCS complicated by simultaneous epistaxis during a long term video-electroencephalographic monitoring. RESULTS: Initially, SPECT images showed an unexpected hot spot at the skull base suggesting pharyngeal or pituitary tumors. Clinical history disclosed chronic sinusitis and rare episodes of epistaxis. White and red cells blood count, platelet count, serum biochemistry, coagulation tests, and rest arterial blood pressure were normal. Computed tomography and MRI excluded sinusoidal expansive or vascular lesions, head trauma, fractures or acute infections. Subtracted SPECT disclosed a focal high concentration of the radiotracer within the left sphenoid sinus, probably related to the nose bleeding. CONCLUSION: This is a singular case of a brain SPECT artifact secondary to a nasal bleeding during a generalized seizure that was misinterpreted as neoplastic disease. Also, this case raises concerns about the pathophysiological relationship among epileptic seizures, nasal bleedings and chronic sinusitis. |
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Journal of epilepsy and clinical neurophysiology (Online) |
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Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull baseepilepsyepistaxisgeneralized seizureSISCOMSPECTINTRODUCTION: Generalized tonic-clonic seizures (GTCS) are among the most dramatic types of epileptic seizures and may be accompanied by rising blood pressure and pulse rate, physical injuries from falling, muscular convulsions, tongue biting, or aspiration pneumonia. Epistaxis is an uncommon complication of generalized seizures and investigations should exclude local or systemic disorders. OBJECTIVE: We aim to report a 29-year-old male patient with medically intractable right temporal lobe epilepsy whose ictal SPECT showed a conspicuous high extracerebral accumulation of the tracer at the skull base. METHODS: The tracer 99mTc-ECD was injected during a GTCS complicated by simultaneous epistaxis during a long term video-electroencephalographic monitoring. RESULTS: Initially, SPECT images showed an unexpected hot spot at the skull base suggesting pharyngeal or pituitary tumors. Clinical history disclosed chronic sinusitis and rare episodes of epistaxis. White and red cells blood count, platelet count, serum biochemistry, coagulation tests, and rest arterial blood pressure were normal. Computed tomography and MRI excluded sinusoidal expansive or vascular lesions, head trauma, fractures or acute infections. Subtracted SPECT disclosed a focal high concentration of the radiotracer within the left sphenoid sinus, probably related to the nose bleeding. CONCLUSION: This is a singular case of a brain SPECT artifact secondary to a nasal bleeding during a generalized seizure that was misinterpreted as neoplastic disease. Also, this case raises concerns about the pathophysiological relationship among epileptic seizures, nasal bleedings and chronic sinusitis.Liga Brasileira de Epilepsia (LBE)2006-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000700007Journal of Epilepsy and Clinical Neurophysiology v.12 n.4 2006reponame:Journal of epilepsy and clinical neurophysiology (Online)instname:Liga Brasileira de Epilepsia (LBE)instacron:LBE10.1590/S1676-26492006000700007info:eu-repo/semantics/openAccessWichert-Ana,LauroFerruzzi,Emerson HenklainAlexandre Jr,VerianoVelasco,Tonicarlo RodriguesBianchin,Marino MuxfeldtTerra-Bustamante,Vera CristinaKato,MerySantos,Antonio CarlosAzevedo-Marques,Paulo Mazzoncini deOliveira,Lucas Ferrari deSakamoto,Américo Ceikieng2007-05-22T00:00:00Zoai:scielo:S1676-26492006000700007Revistahttp://epilepsia.org.br/publicacoes/ONGhttps://old.scielo.br/oai/scielo-oai.php||jecnpoa@terra.com.br1980-53651676-2649opendoar:2007-05-22T00:00Journal of epilepsy and clinical neurophysiology (Online) - Liga Brasileira de Epilepsia (LBE)false |
dc.title.none.fl_str_mv |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
title |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
spellingShingle |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base Wichert-Ana,Lauro epilepsy epistaxis generalized seizure SISCOM SPECT |
title_short |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
title_full |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
title_fullStr |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
title_full_unstemmed |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
title_sort |
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base |
author |
Wichert-Ana,Lauro |
author_facet |
Wichert-Ana,Lauro Ferruzzi,Emerson Henklain Alexandre Jr,Veriano Velasco,Tonicarlo Rodrigues Bianchin,Marino Muxfeldt Terra-Bustamante,Vera Cristina Kato,Mery Santos,Antonio Carlos Azevedo-Marques,Paulo Mazzoncini de Oliveira,Lucas Ferrari de Sakamoto,Américo Ceiki |
author_role |
author |
author2 |
Ferruzzi,Emerson Henklain Alexandre Jr,Veriano Velasco,Tonicarlo Rodrigues Bianchin,Marino Muxfeldt Terra-Bustamante,Vera Cristina Kato,Mery Santos,Antonio Carlos Azevedo-Marques,Paulo Mazzoncini de Oliveira,Lucas Ferrari de Sakamoto,Américo Ceiki |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Wichert-Ana,Lauro Ferruzzi,Emerson Henklain Alexandre Jr,Veriano Velasco,Tonicarlo Rodrigues Bianchin,Marino Muxfeldt Terra-Bustamante,Vera Cristina Kato,Mery Santos,Antonio Carlos Azevedo-Marques,Paulo Mazzoncini de Oliveira,Lucas Ferrari de Sakamoto,Américo Ceiki |
dc.subject.por.fl_str_mv |
epilepsy epistaxis generalized seizure SISCOM SPECT |
topic |
epilepsy epistaxis generalized seizure SISCOM SPECT |
description |
INTRODUCTION: Generalized tonic-clonic seizures (GTCS) are among the most dramatic types of epileptic seizures and may be accompanied by rising blood pressure and pulse rate, physical injuries from falling, muscular convulsions, tongue biting, or aspiration pneumonia. Epistaxis is an uncommon complication of generalized seizures and investigations should exclude local or systemic disorders. OBJECTIVE: We aim to report a 29-year-old male patient with medically intractable right temporal lobe epilepsy whose ictal SPECT showed a conspicuous high extracerebral accumulation of the tracer at the skull base. METHODS: The tracer 99mTc-ECD was injected during a GTCS complicated by simultaneous epistaxis during a long term video-electroencephalographic monitoring. RESULTS: Initially, SPECT images showed an unexpected hot spot at the skull base suggesting pharyngeal or pituitary tumors. Clinical history disclosed chronic sinusitis and rare episodes of epistaxis. White and red cells blood count, platelet count, serum biochemistry, coagulation tests, and rest arterial blood pressure were normal. Computed tomography and MRI excluded sinusoidal expansive or vascular lesions, head trauma, fractures or acute infections. Subtracted SPECT disclosed a focal high concentration of the radiotracer within the left sphenoid sinus, probably related to the nose bleeding. CONCLUSION: This is a singular case of a brain SPECT artifact secondary to a nasal bleeding during a generalized seizure that was misinterpreted as neoplastic disease. Also, this case raises concerns about the pathophysiological relationship among epileptic seizures, nasal bleedings and chronic sinusitis. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000700007 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492006000700007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1676-26492006000700007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Liga Brasileira de Epilepsia (LBE) |
publisher.none.fl_str_mv |
Liga Brasileira de Epilepsia (LBE) |
dc.source.none.fl_str_mv |
Journal of Epilepsy and Clinical Neurophysiology v.12 n.4 2006 reponame:Journal of epilepsy and clinical neurophysiology (Online) instname:Liga Brasileira de Epilepsia (LBE) instacron:LBE |
instname_str |
Liga Brasileira de Epilepsia (LBE) |
instacron_str |
LBE |
institution |
LBE |
reponame_str |
Journal of epilepsy and clinical neurophysiology (Online) |
collection |
Journal of epilepsy and clinical neurophysiology (Online) |
repository.name.fl_str_mv |
Journal of epilepsy and clinical neurophysiology (Online) - Liga Brasileira de Epilepsia (LBE) |
repository.mail.fl_str_mv |
||jecnpoa@terra.com.br |
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1754734659124592640 |