Cavum vergae

Cavum Septum Pellucidum Et Vergae y Epileptogénesis

The prevalence of Cavum septum pellucidum (CSP) and Cavum vergae (CV) is unknown. Bruyn et al, observed that 30-50 % of subjects with CSP had epileptic seizures and manifested some degree of psychosis, dementia or personality disorders. The presence of CSP was higher in patients with extra-temporal epilepsy than in temporal lobe epilepsy and also higher in patients with neuronal migration disorder than without.

We present the case of a woman with focal epilepsy since childhood, who restarted seizures in adulthood, with no family history of epilepsy, whose son with chromosomopathy 18 died 21 days after birth. Cranial MRI showed a CSP and a CV, EEG (electroencephalogram) confirmed a left temporal focus and epilepsy was controlled with eslicarbazepine 800 mg.

We can conclude that the presence of CSP and CV is not a simple anatomical variation but may be related to the occurrence of epilepsy being a developmental anomaly that may contribute to epileptogenesis, as well as a marker of poor seizure control. We alert clinicians to be aware of this malformation in cases of diagnostic uncertainty. In addition, a wide CSP would justify a more detailed ultrasound examination and genetic counseling in trisomy 18 fetuses.

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Palabras clave: Anomalía del desarrollo, Cavum Septum Pellucidum, Cavum vergae, Epileptogénesis, Mal control de crisis epiléptica,

Keywords: Cavum Septum Pellucidum, Cavum vergae, Developmental anomaly, Epileptogenesis, Marker of poor seizure control,

Midline Cava And Limbic System Dysfunction In Community-Dwelling Individuals Aged ≥20 Years Living In Rural Ecuador. A Case-Control Study Nested To A Population-Based Cohort. Cavum de Línea Media y Disfunción del Sistema Límbico en Individuos de 20 Años o Más Que Viven en Zonas Rurales Del Litoral Ecuatoriano. Estudio de Caso-Control Anidado en Una Cohorte Poblacional

Background: Persistence of cavum septum pellucidum (CSP) and cavum vergae (CV) into adulthood and their association with mood disorders is unknown. Objective: We aimed to assess persistence of these cava in Atahualpa cohort individuals, and their association with clinical depression (as a surrogate of limbic system dysfunction). Methods: Cases were defined as Atahualpa residents aged ≥20 years with CSP and/or CV and paired 1:1 to age- and sex-matched randomly-selected controls. A board-certified psychiatrist (blinded to case-control status) interviewed individuals with the aid of the Patient Health Questionnaire depression module (PHQ-9) to establish a diagnosis of clinical depression. The McNemar’s test and conditional logistic regression models were fitted to assess the independent association between persistence of CSP and/or CV and clinical depression (as the dependent variable). Results: Of 1,298 individuals undergoing a head CT, 51 (3.9%) had a CSP and/or CV. The selection process for the nested case-control study on the Atahualpa cohort (after excluding eight missing individuals with midline cava) generated 43 pairs. Nine of 43 case-patients (20.9%) and only two control subjects (4.7%) had moderate-to-severe scores on the PHQ-9 (cutoff ≥10 points). Clinical depression was significantly more frequent among case-patients than controls by the McNemar’s test (OR: 8; 95% C.I.: 1.1 – 354.9) and the conditional logistic regression model (OR: 8; 95% C.I.: 1.00 – 63.96). Conclusions: This study provides epidemiological evidence favoring the association between midline cava and clinical depression, supporting their relationship with limbic system dysfunction.