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Drug-resistant epilepsy, early-onset hypertension and white matter lesions: a hidden paraganglioma

Silvennoinen, K; Waghorn, A; Balestrini, S; Sisodiya, S; (2019) Drug-resistant epilepsy, early-onset hypertension and white matter lesions: a hidden paraganglioma. BMJ Case Reports , 12 (6) , Article e228348. 10.1136/bcr-2018-228348. Green open access

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Abstract

We describe the case of a 35-year-old man with focal epilepsy since age 16. Due to a refractory course, several treatments were tried over the years, including insertion of a deep brain stimulator. At the time of his first assessment at our unit, he had recently been diagnosed with hypertension. An MR scan of brain revealed multiple T2 hyperintense white matter lesions, and evidence of previous haemorrhage in the left basal ganglia and pons. On follow-up imaging, the changes were considered to be in keeping with hypertensive arteriopathy. He was referred for further assessment of his hypertension and was found to have a para-aortic paraganglioma. This was excised 16 months after his initial presentation to us. The surgery was associated with an improvement in his seizure control. This case serves as a reminder of the need to be vigilant about the possibility of coexisting conditions in people with epilepsy.

Type: Article
Title: Drug-resistant epilepsy, early-onset hypertension and white matter lesions: a hidden paraganglioma
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bcr-2018-228348
Publisher version: https://doi.org/10.1136/bcr-2018-228348
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10074613
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