PMC6921157_01
(A-D) A cluster of multiple nodular high intensity lesions without mass effect (arrowheads), which was compatible with multinodular and vacuolating neuronal tumor (MVNT), was shown in the white matter of the left temporal lobe in fluid-attenuated inversion recovery (FLAIR) of brain magnetic resonance imaging (MRI). (E) Moderately reduced uptake of nuclide (arrows) was detected in the lesion area in 18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET) of brain.
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T2-weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) in white matter of the left temporal lobe along with the border of inner cortex (Fig. 1A). The lesions did not show any mass effect or enhancement with gadolinium. The characteristics of MRI findings were consistent with those of MVNT. 18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET) of brain demonstrated moderate decrease of uptake in the lesion area (Fig. 1B).
Long-term video electroencephalogram demonstrated two types of seizures: (A) Rhythmic waves started from middle-temporal area (T3) and gradually increased its amplitudes and spread to ipsilateral frontal area, then to the contralateral hemisphere; (B) The similar pattern of rhythmic waves started from the right anterior-temporal area (F8).
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Her consciousness was partially impaired during the seizure. vEEG showed rhythmic wave that started from the left middle temporal area and spread to the ipsilateral frontal region, and then to the contralateral hemisphere (Fig. 2A); The other started with lightheadedness and vEEG showed similar rhythmic waves that started from the right anterior temporal area (Fig. 2B).