Pituitary Apoplexy Accompanying Temporal Lobe Seizure as a Complication

World Neurosurg. 2020 Jun:138:153-157. doi: 10.1016/j.wneu.2020.02.148. Epub 2020 Mar 5.

Abstract

Background: Pituitary apoplexy is an acute clinical syndrome caused by infarction and/or hemorrhage of pituitary adenoma, which typically presents with severe headache, visual deterioration, and endocrine abnormalities. However, temporal lobe seizure (and temporal lobe epilepsy) has not been viewed as a symptom of pituitary apoplexy in the literature.

Case description: To elucidate further such a rare complication of temporal lobe seizure, we describe here the rare clinical manifestations of a 55-year-old previously healthy man with pituitary apoplexy harboring headache, combined palsies involving cranial nerves III to VI, endocrinologic disturbances, and temporal lobe seizure. In addition, we discuss the temporal lobe seizure (and temporal lobe epilepsy) associated with pituitary adenoma based on the literature.

Conclusions: Although further accumulation of clinical data is needed, we would like to emphasize the importance of recognition of temporal lobe seizure caused by pituitary apoplexy, and to suggest that early surgery could be considered as an option in patients displaying such a rare complication.

Keywords: Cavernous sinus; Epilepsy; MRI; Pituitary adenoma; Pituitary apoplexy; Temporal lobe; Temporal lobe seizure.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications
  • Epilepsy, Temporal Lobe / complications*
  • Epilepsy, Temporal Lobe / diagnostic imaging
  • Headache / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Oculomotor Nerve Diseases / etiology
  • Pituitary Apoplexy / complications*
  • Pituitary Apoplexy / surgery
  • Pituitary Neoplasms / complications
  • Seizures / complications*
  • Seizures / diagnostic imaging
  • Seizures / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Trochlear Nerve Diseases / etiology