UNUSUAL ASSOCIATION OF INTRACTABLE TEMPORAL-LOBE SEIZURES AND INTRACRANIAL ANEURYSMS IN AN ADOLESCENT - IS IT A COINCIDENCE

Intracranial aneurysms in the pediatric age group are rare occurrences . They usually present with subarachnoid hemorrhage or mass effect. Th eir association with epilepsy has rarely been reported; such concurren ce may not be a coincidence. We present a 16-year-old girl with a 5-ye ar history of medically intractable complex partial seizures. Preopera tive electrophysiological and neuroimaging studies demonstrated an epi leptogenic focus and atrophy in the right mesial temporal lobe, and ip silateral incidental aneurysm at the carotid artery bifurcation. The p atient underwent a complete right anterior temporal lobectomy, followe d by clipping of the aneurysm. We concluded that the epilepsy manageme nt in association with cerebral aneurysms is controversial, but when s urgery is indicated, clipping of the aneurysm and resection of the epi leptogenic focus may provide the optimal outcome. The relevant literat ure is reviewed and the possible mechanisms of production of epilepsy by intracranial aneurysms are discussed.