Ulnar Neuropathy Caused by a Giant Epidermal Cyst at the Elbow: Case Report.

Here, we report an unusual case of ulnar neuropathy at the elbow caused by a giant epidermal cyst. A 76-year-old man was assessed on an outpatient basis for ulnar numbness of the left hand that had persisted for 6 months. A soft, elastic subcutaneous mass 6 cm in size was noted on his left elbow. He felt numbness on the ulnar aspect of the left fourth and fifth fingers, corresponding to the area innervated by the ulnar nerve, which worsened upon elbow flexion. An electrophysiological study revealed ulnar neuropathy at the elbow. To remove the subcutaneous mass at the left elbow and open up the ulnar tunnel, surgery was performed. There were no signs of nerve impingement or a neuroma on the ulnar nerve. The histological diagnosis was an epidermal cyst. On the day after surgery, numbness on the ulnar aspect of the left hand upon elbow flexion was markedly abated.

[Ictal EEG pattern of transient epileptic amnesia in acute phase of non-herpetic limbic encephalitis].

A 60-year-old, right-handed woman was admitted to our hospital for amnesia as the only neurological abnormal findings following the autonomic symptoms and transient episodes of loss of awareness. EEG during the amnesia showed rhythmic alpha activity arising from the left mid-temporal region. Although this ictal activity showed evolution in the frequency and amplitude, the location was limited in the bilateral temporal areas. After the EEG evaluation, her amnesia was resolved immediately, suggesting that her presentation was transient epileptic amnesia (TEA). Meanwhile, given the clinical course and MRI findings (high intensity in the bilateral mesial temporal areas, more on the left), she was diagnosed with non-herpetic limbic encephalitis and treated with steroid and anti-epileptic drugs, leading to the positive outcome. The ictal EEG findings during TEA as the one of the presentation in acute phase of non-herpetic limbic encephalitis may contribute to further investigation of underlying mechanism of TEA.

[Clinical presentations of Ross syndrome have changed in their lateralities following the anteriotemporal lobectomy for refractory focal epilepsy].

We describe a 60-year-old woman with medically refractory left mesial temporal lobe epilepsy accompanied by Ross syndrome. The patient had a partial triad of Ross syndrome with hypohydrosis only on her right side (contralateral to the epileptic seizure focus), Adie's tonic pupil on the right, and areflexia while her seizures used to be medically refractory. However, her hypohidrosis and Adie's tonic pupil have completely changed in terms of laterality following nearly complete seizure freedom resutling from left temporal lobectomy. This unique change in laterality in Ross syndrome is most likely caused by remote effects of the near-absent epileptic acitivity, and it also may contribute to understanding the pathophysiological mechanism of Ross syndrome.