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.
