Adult case of moyamoya disease with intractable epileptic seizures

Abstract

We report a case of moyamoya disease in an adult with intractable complex partial seizures who was treated for temporal lobe epilepsy. The patient was a 36-year-old man who experienced a partial seizure consisting of loss of consciousness with vomiting at the age of 8 years. His EEG showed spikes with slow waves in the left temporal region. On the basis of these clinical symptoms and the results of the EEG, he was diagnosed with temporal lobe epilepsy. Despite treatment with various antiepileptic drugs, the seizures recurred monthly. At the age of 27, he had generalized convulsive status epilepticus followed by prolonged confusion. After this episode, his MRI showed bilateral hippocampal sclerosis and right frontal lesion. At the age of 36 years, he was found in a state of confusion. His MRI and MRA showed cerebral hemorrhage and moyamoya disease was diagnosed. Longstanding epileptic seizure without stroke is rare in an adult with moyamoya disease. The two conditions may have been comorbid in this case, although it is possible that the pathophysiology of the moyamoya disease evoked the epileptic seizures.