A Rare Case of Epilepsia Partialis Continua Caused by a Transient Thalamic Pulvinar Lesion

Abstract

Epilepsia partialis continua (EPC) is a subclass of focal motor status epilepticus. Despite the evidence for a cortical origin, subcortical pathologies-especially those involving the thalamus-have been proposed. Here, we report a case of EPC with focal faciobrachial seizures, with a reversible pulvinar thalamic lesion detected on magnetic resonance imaging (MRI), such as has not previously been reported. An 89-year-old man presented to our emergency department with a three-hour history of right-sided continuous faciobrachial seizure activity. Diffusion-weighted images showed hyperintensity in the left thalamus in the pulvinar region. Follow-up MRI revealed complete resolution of the abnormal signal in the same region. Our case was interesting because of the EPC caused by a transient thalamic pulvinar lesion in an unusual localization in an elderly patient with no previous brain lesions.

Keywords

• epilepsia partialis continua
• faciobracial seizure
• magnetic resonance imaging
• thalamus
• pulvinar