Meningioangiomatosis: an uncommon cause of focal epilepsy with characteristic neuroimaging and neuropathology

Epileptic seizures revealing tuberous sclerosis in a tropical environment: A study of 12 case series

Background

Epilepsy remains a significant public health concern in Sub-Saharan Africa (SSA) where diverse etiological factors contribute to its prevalence. Among these factors are conditions originating from the neuroectoderm, such as tuberous sclerosis. Insufficient medical attention and a lack of comprehensive multidisciplinary care contribute to its under-recognition.

Materials and methods

We conducted a retrospective descriptive study, involving 12 patients admitted to the neurology and pediatric departments of the University Hospital Ignace Deen between 2010 and 2022 due to recurring epileptic seizures. Subsequently, these patients were diagnosed with Tuberous sclerosis using the Schwartz 2007 criteria. The aim of this study is to reassess this condition from a clinical and paraclinical point of view in a tropical environment.

Results

Tuberous sclerosis, also known as Bourneville disease, was diagnosed in 12 patients exhibiting focal motor seizures and complex focal seizures likely associated with cortical and subcortical tubers detectable by EEG and neuroimaging, including CT and MRI. Delayed treatment resulted in varying degrees of mental decline. Additionally, some patients displayed cardiac hamartomas and intracranial posterior and anterior aneurysms as minor diagnostic indicators.

Conclusion

The study reveals a consistent clinical presentation accompanied by deteriorating neurological and psychological symptoms attributed to delayed multidisciplinary management. These findings are utilized to assess therapeutic strategies and prognostic outcomes.

Magnetic Resonance Spectroscopy May Help Diagnose Sporadic Meningioangiomatosis Associated With Meningioma: A Case Report

Herein, we have presented the clinical features of meningioangiomatosis associated with meningioma, which is considered to be a rare neoplastic lesion. Magnetic resonance spectroscopy (MRS) demonstrated a remarkably decreased N-acetylaspartate peak and an increase in the choline peak of the lesion, suggesting neuronal injury and active cell proliferation. These findings substantially differed from those observed in the case of pure meningioangiomatosis.

Cystic meningioangiomatosis and cerebellar ependymoma in a child with neurofibromatosis type 2

We report a case of multifocal cystic meningioangiomatosis (MA), an exceptionally uncommon diagnosis even in patients with type 2 neurofibromatosis (NF2). A 2-year-old male with personal as well as family history of genetically-confirmed NF2 presented with incidental findings of MA after imaging for closed-head injury. Computed tomography and magnetic resonance imaging revealed multifocal subcortical and basal ganglia cysts, enhancing tumor-like vascular encasement, and a cerebellar ependymoma with atypical features. Given the paucity of available literature describing this pathology, imaging findings are discussed to further characterize this elusive disease. Radiologists must keep in mind that children with NF2 may not only present with MA, but also a constellation of MA with classic NF tumors, including ependymoma as in this case.