An 8‐Year‐Old Girl with Blepharospasm and Left Thalamic Tumor

Abstract

An eight-year-old female patient, who was previously healthy, presented with episodes of a headache followed by recurrent bilateral eyelid movements described as a heartbeat that lasts few seconds following by spontaneous remission without loss of consciousness. These symptoms were experienced periodically for about 30 days. On physical examination, the patient showed no motor, sensory, or cognitive deficits. A CT brain scan revealed a left thalamic mass lesion without contrast enhancement. MRI revealed an extensive left thalamic tumor that was hypointense/isointense on T1-weighted MRI, hyperintense on T2-weighted MRI. The sagittal (Figure 1A) and coronal (Figure 1B) views of a T1-weighted MRI after gadolinium injection evidenced no-enhancement of a large anterodorsal left thalamic tumor compressing the third ventricle. While the axial view of a FLAIR MRI showed the hyperintensity of a large tumor in the left thalamus (Figure 1C). A transcranial EEG showed no abnormalities. The patient underwent microsurgery to resect the tumor using a left frontal transcortical approach that was performed with the aid of surgical microscope and intraoperative electrophysiological monitoring of somatosensory evoked potentials. The patient achieved gross total resection of the tumor (Figure 1D, E) and experienced no postoperative deficits or any episodes of blepharospasm even from the first postoperative day. The patient remains on outpatient follow-up after 15 months without adjuvant treatment, and the most recent brain MRI revealed no recurrence of the injury.