Generalized convulsive status epilepticus induced by occipital lobe arteriovenous malformation: A case report

Abstract

Background. Arteriovenous malformations (AVMs) are abnormal tangles of blood vessels that connect arteries and veins, disrupting normal blood flow and oxygen circulation. Although AVMs can occur in various regions of the brain, their presence in the occipital lobe and their potential to induce generalized convulsive status epilepticus (GCSE) are considered rare. This case report aims to describe a unique presentation of GCSE induced by an AVM located in the occipital lobe. Case report. A 64-year-old patient was brought to the emergency department in an unconscious state after experiencing two seizures. Whole-body convulsions lasting 5–6 minutes were observed, despite the absence of a prior seizure history. Before the seizures, the patient reported symptoms of weakness, vomiting, and severe dizziness, although no sensory loss was noted. Post-seizure, cyanosis and snoring were present, and the patient remained unconscious and confused, without limb weakness or slurred speech. Physical examination revealed postictal confusion and cyanosis. Imaging studies, including MRI, showed an abnormal flow void on T2 FLAIR in the right occipital lobe, accompanied by multiple niduses. Further evaluation via MRA confirmed the presence of an AVM in the right occipital region, with feeding from the posterior cerebral artery (P2 branch) and draining into the right basal and frontal veins. Conclusions. This case highlights the need for awareness of rare etiologies, such as AVMs in the occipital lobe, in patients with new-onset seizures. Prompt diagnosis and appropriate management are essential for reducing the risks associated with GCSE and improving the quality of life of affected individuals.