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All Journal Althea Medical Journal MNJ (Malang Neurology Journal) Universa Medicina Majalah Kedokteran Neurosains Biomolecular and Health Science Journal Indian Journal of Forensic Medicine & Toxicology AKSONA Magna Neurologica
Achmad Firdaus Sani, Achmad Firdaus
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga; RSUD Dr. Soetomo, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Cerebral Proliferative Angiopathy as the Cause of Symptomatic Epilepsy in a Young Adult Male: A First Case Report from Indonesia Swatan, Jovian Philip; Sani, Achmad Firdaus; Islamiyah, Wardah Rahmatul; Kurniawan, Dedy; Fatimah, Ersifa
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.895

Abstract

Background: Cerebral proliferative angiopathy (CPA) is a rare and distinct vascular malformation that was once considered a subset of cerebral arteriovenous malformation (AVM). Due to its relatively benign course with no distinctive clinical feature, CPA may often be overlooked and misdiagnosed with other diseases. We would like to report a case of CPA as the underlying cause of symptomatic epilepsy. Case: A 31-year-old male presented to the outpatient clinic with a history of focal to bilateral tonic-clonic seizure for 2 years. Following conservative management with an oral antiepileptic agent, the seizure frequency significantly decreased from once daily to once or twice monthly. The patient was lost to follow-up; however, he was incidentally referred back to our clinic two years later for further evaluation. A head Magnetic Resonance Imaging and Magnetic Resonance Angiography revealed a suspicion of giant AVM in the left hemisphere. Cerebral digital subtraction angiography (DSA) was performed and revealed a CPA in the left frontal area. The patient was managed conservatively, and during the 6-month follow-up period, the patient did not have any seizures. Discussion: In young adults, seizures may be caused by an underlying vascular abnormality. Cerebral DSA remained the gold standard for distinguishing various etiologies of vascular malformation, including CPA. Conclusion: Conservative treatment using oral antiepileptic agents was effective in controlling the seizure frequency in CPA. However, a complete diagnostic evaluation is still warranted to determine the most appropriate treatment while revealing some peculiar and unexpected etiologies in the process.
Co-Authors Adrianto, Yudhi Archangela Olivia Eugenia Ardhi, Mohammad Saiful Basuki, Mudjiani Chandrawati Widya Hartati Darmawan, Ahmad Faisal Dedy Kurniawan Fadil Fadil Fatimah, Ersifa Fidiana Fidiana, Fidiana Fritz Sumantri Usman, Fritz Sumantri Hermawan Susanto Islamiyah, Wardah Rahmatul Jongky Hendro Prajitno MARIA BINTANG Mohammad Pratama Jauhar Putra Muh. Wildan Yahya Puji Lestari Ramadhania, Nadya Noor Rizky Hartono Rizky Hartono, Rizky Shakir Husain, Shakir Sita Setyowatie Swatan, Jovian Philip Taurus Laisari Yusak Maryunianta