Clinical reasoning: a 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades.

A 30-year-old woman presented with a history of generalized tonic-clonic seizures since childhood, occurring for the first time at age 9. The initial diagnostic workup at age 13 demonstrated a distinctive calcified mass of the left frontal lobe on CT (figure, A). Together with a single facial nevus, the lesion was suspected to represent Sturge-Weber-like phakomatosis; however, the patient’s clinical history and physical examination failed to reveal further evidence of a neurocutaneous syndrome. Neither MRI nor biopsy for histologic confirmation of the diagnosis was performed. At age 18 the patient was lost to follow-up at the children’s hospital. DOI: https://doi.org/10.1212/WNL.0000000000000122 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-95407 Accepted Version Originally published at: Tonder, Michaela; Rushing, Elisabeth Jane; Grotzer, Michael; Sürücü, Oguzkan; Valavanis, Antonios; Buck, Alfred; Weller, Michael; Roth, Patrick (2014). Clinical reasoning: a 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades. Neurology, 82(7):e56-e60. DOI: https://doi.org/10.1212/WNL.0000000000000122 NEUROLOGY/2013/528406 A 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades M Tonder, MD, EJ Rushing, MD, M Grotzer, MD, O Sürücü, MD, A Valavanis, MD, A Buck, MD, M Weller, MD, P Roth, MD Departments of Neurology, Neurosurgery, Neuroradiology and Nuclear Medicine, and Institute of Neuropathology, University Hospital Zurich, Zurich, Switzerland; Department of Oncology, University Children's Hospital of Zurich, Zurich, Switzerland Word count: 1421; characters title: 92 References: 10; Figures: 1 Search terms: [60] All epilepsy, [122] PET, [214] Primary brain tumor *Correspondence: Dr. Patrick Roth, Brain Tumor Center Zurich and Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland, Tel.: +41 44 255 5511, Fax: +41 44 255 4380, E-mail: [email protected]