Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome

Limited scleroderma, also termed CREST syndrome (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia), is a form of scleroderma which is an autoimmune connective tissue disease. Neurological involvement is less common than other system involvements in scl...

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Main Authors: Mustafa Açıkgöz, Esra Acıman Demirel, Serdar Güdül, Ulufer Çelebi, Birol Özkal, Hüseyin Tuğrul Atasoy
Format: Article
Language:English
Published: Galenos Yayinevi 2017-12-01
Series:Türk Nöroloji Dergisi
Subjects:
Online Access:http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-27048
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author Mustafa Açıkgöz
Esra Acıman Demirel
Serdar Güdül
Ulufer Çelebi
Birol Özkal
Hüseyin Tuğrul Atasoy
author_facet Mustafa Açıkgöz
Esra Acıman Demirel
Serdar Güdül
Ulufer Çelebi
Birol Özkal
Hüseyin Tuğrul Atasoy
author_sort Mustafa Açıkgöz
collection DOAJ
description Limited scleroderma, also termed CREST syndrome (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia), is a form of scleroderma which is an autoimmune connective tissue disease. Neurological involvement is less common than other system involvements in scleroderma. Epileptic seizure is a rare neurological complication. Gyral enhancement is not an expected finding during disease. Gyral enhancement is contrast enhancement of superficial brain parenchyma and it usually occurs as a result of vascular, inflammatory, infectious and neoplastic processes. A-sixty-seven-year old female patient, who was diagnosed as CREST syndrome for three years was admitted to our hospital. She had an epileptic seizure three days ago and behavioral changes after the seizure. There was not epilepsy diagnosis in her medical history. In neurological examination; she was apathic and deep tendon reflexes were hyperactive, Hoffman’s and Babinski reflexes were positive on the right side of her body. In laboratory studies; anti-nuclear antibody was positive at 1/1000 and anti-centromere antibody was positive. On contrast-enhanced cranial magnetic resonance imaging (MRI); gyral enhancement was observed in the left parieto-occipital region. Cerebrospinal fluid tests were within normal limits. Electroencephalography demonstrated diffuse cerebral dysfunction. We administrated antiepileptic drug to the patient during hospitalization. On the follow up, apathy and restriction of the cooperation were improved. Epileptic seizure did not recur. After ten days, in the control cranial MRI, gyral enhancement was reduced significantly. Neurological involvement in CREST syndrome is rare and epileptic seizures have been appeared in a limited number in the literature. Inflammatory and vascular processes can cause gyral enhancement, but also it must be kept in mind that gyral enhancement can be observed transiently after epileptic seizure
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spelling doaj.art-2e987ac54b4d45b298db382c13dee8e22023-02-15T16:10:57ZengGalenos YayineviTürk Nöroloji Dergisi1301-062X1309-25452017-12-0123422923310.4274/tnd.27048Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST SyndromeMustafa Açıkgöz0Esra Acıman Demirel1Serdar Güdül2Ulufer Çelebi3Birol Özkal4Hüseyin Tuğrul Atasoy5Bulent Ecevit University Faculty of Medicine, Department of Neurology, Zonguldak, TurkeyBulent Ecevit University Faculty of Medicine, Department of Neurology, Zonguldak, TurkeyKaradeniz Eregli State Hospital, Clinic of Neurology, Zonguldak, TurkeyBulent Ecevit University Faculty of Medicine, Department of Neurology, Zonguldak, TurkeyAlanya State Hospital, Clinic of Neurosurgery, Antalya, TurkeyBulent Ecevit University Faculty of Medicine, Department of Neurology, Zonguldak, TurkeyLimited scleroderma, also termed CREST syndrome (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia), is a form of scleroderma which is an autoimmune connective tissue disease. Neurological involvement is less common than other system involvements in scleroderma. Epileptic seizure is a rare neurological complication. Gyral enhancement is not an expected finding during disease. Gyral enhancement is contrast enhancement of superficial brain parenchyma and it usually occurs as a result of vascular, inflammatory, infectious and neoplastic processes. A-sixty-seven-year old female patient, who was diagnosed as CREST syndrome for three years was admitted to our hospital. She had an epileptic seizure three days ago and behavioral changes after the seizure. There was not epilepsy diagnosis in her medical history. In neurological examination; she was apathic and deep tendon reflexes were hyperactive, Hoffman’s and Babinski reflexes were positive on the right side of her body. In laboratory studies; anti-nuclear antibody was positive at 1/1000 and anti-centromere antibody was positive. On contrast-enhanced cranial magnetic resonance imaging (MRI); gyral enhancement was observed in the left parieto-occipital region. Cerebrospinal fluid tests were within normal limits. Electroencephalography demonstrated diffuse cerebral dysfunction. We administrated antiepileptic drug to the patient during hospitalization. On the follow up, apathy and restriction of the cooperation were improved. Epileptic seizure did not recur. After ten days, in the control cranial MRI, gyral enhancement was reduced significantly. Neurological involvement in CREST syndrome is rare and epileptic seizures have been appeared in a limited number in the literature. Inflammatory and vascular processes can cause gyral enhancement, but also it must be kept in mind that gyral enhancement can be observed transiently after epileptic seizurehttp://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-27048CREST syndromeepileptic seizuregyral enhancement
spellingShingle Mustafa Açıkgöz
Esra Acıman Demirel
Serdar Güdül
Ulufer Çelebi
Birol Özkal
Hüseyin Tuğrul Atasoy
Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
Türk Nöroloji Dergisi
CREST syndrome
epileptic seizure
gyral enhancement
title Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
title_full Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
title_fullStr Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
title_full_unstemmed Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
title_short Transient Gyral Enhancement After Epileptic Seizure in a Patient with CREST Syndrome
title_sort transient gyral enhancement after epileptic seizure in a patient with crest syndrome
topic CREST syndrome
epileptic seizure
gyral enhancement
url http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-27048
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AT ulufercelebi transientgyralenhancementafterepilepticseizureinapatientwithcrestsyndrome
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