Brain Lesions in Children Challenging to Diagnose

According to a study recently published in the journal Frontiers in Neurology, brain lesions in children can be particularly difficult to diagnose due to a variety of underlying etiologies which can be challenging to differentiate on neuroimaging machines. The study, conducted by a research team at Loyola University Medical Center, cited a case of a 12-year-old boy who came to his primary-care physician with staring episodes, which lasted about one minute each, during which time he was unresponsive and made wringing motions with his hands. An MRI initially showed a lesion in the mesial temporal lobe, and the boy underwent surgery to remove a large portion of the lesion. However, five years post-surgery he continued to have two to three seizures per month, despite taking two anti-seizure medications. After a second surgery, pathology showed the lesion was consistent with an arteriovenous malformation. Three years after his second surgery, the boy remained seizure free. The case highlights the challenge in distinguishing different lesions based on imaging, highlighting the importance of carefully analyzing available imaging in order to obtain as much information as possible. “When a diagnosis remains unclear, biopsy needs to be considered, but ultimately it is the entire work-up and clinical picture that will lead to a correct diagnosis,” researchers wrote. To read more about this study, click here.