AN UNCOMMON PRESENTATION OF SEPTUM PELLUCIDUM ANATOMICAL VARIATIONS: A CASE REPORT OF GENERALIZED TONIC-CLONIC SEIZURE IN A HEALTHY ADULT

Öz

ABSTRACT: Introduction: The septum pellucidum (SP) is a thin, transparent, dual-membrane structure located between the lateral ventricles of the brain. Incidentally identified through imaging modalities, this variation, while rare, may manifest with symptoms such as neuropsychiatric disorders, headache, dizziness, seizures, nausea, and vomiting. In this report, we present the case of a healthy middle-aged man with CV and CSP, who sought medical attention in the emergency department (ED) due to a generalized tonic-clonic seizure (GTCS). Case Report: A 40-year-old male without any known medical history presented to our emergency department with a GTCS. Considering this as the first seizure, blood and imaging tests were conducted, all of which showed no abnormalities. Non-contrast computed tomography revealed sequel cystic encephalomalacic areas in the left occipital and right frontal cerebral hemispheres, consistent with a parapharyngeal epidermoid cyst, and the presence of cavum septum pellucidum et vergae. Emergency consultation from the neurological clinic was sought, and an electroencephalogram showed no seizure activity. He was subsequently discharged with a recommendation for follow-up at the neurology outpatient clinic. Conclusion: This case prompts critical considerations in the emergency medicine realm regarding the potential relationship between anatomical variations in the septum pellucidum and emergent seizure activity. Keywords: Septum pellucidum, seizure, cavum vargae, emergency

Anahtar Kelimeler

• Septum pellucidum
• seizure
• cavum vargae
• emergency

Kaynakça

1. 1. Rajasekharan C, Karthik V, Harikrishnan M, Lekshmi S. Cavum vergae and psychiatric illness: substantive or serendipity? BMJ Case Rep. 2018 Jun 28;2018:bcr2018225511. doi: 10.1136/bcr-2018-225511. PMID: 29954773; PMCID: PMC6040555.
2. 2. Ferreira DBCO, Medeiros JW, Cwajg E, Ferreira-Pinto PHC, de Carvalho LU, Nigri F. Cavum septum pellucidum and vergae cyst: A symptomatic case with intracranial hypertension and multiple nerve involvement. Surg Neurol Int. 2022 Dec 2;13:564. doi: 10.25259/SNI_822_2022. PMID: 36600739; PMCID: PMC9805640.
3. 3. Das JM, Dossani RH. StatPearls. Treasure Island, FL: StatPearls Publishing; 2022. Cavum septum pellucidum. Available from: https://www.pubmed.ncbi.nlm.nih.gov/30725733 [Last accessed on 2022 Apr 13]
4. 4. Kryukov EV, Stanishevsky AV, Gavrilov GV, Gizatullin SK. Cysts of septum pellucidum, cavum vergae and cavum veliinterpositi. Meta-analysis of 368 cases. ZhVoprNeirokhirIm N NBurdenko. 2020;84:111–8.
5. 5. Oktem H, Dilli A, Kurkcuoglu A, Pelin C. Prevalence of septum pellucidum variations: A retrospective study. Open Access Libr J. 2018;5:e5017.
6. 6. Martins LP, Leitão AM, de Lucena JD, Gondim FA. Cavum septum pellucidum, da embriologia à clínica: Uma revisão da literatura. J Sağlık Biol Bilim. 2018;7:89–96.
7. 7. Sahin L, Gur A. Association of the Meteorological Parameters and Epileptic Seizures. Int J Crit Care Emerg Med 2023, 9:151.
8. 8. Ekmekyapar T. The effects of systemic inflammatory indices, lactate, and blood gas parameters on drug-resistant and drug-nonresistant epilepsy. Journal of Experimental and Clinical Medicine. 2023:40(3); 640-645.