Abstract Details

Title Dyke-Davidoff-Masson Syndrome in an Adult with Pulmonary Tuberculosis; Diagnostic Challenges and Management Considerations: A Rare Case Report and Literature Review

Topic General Neurology

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 7-012

Objective To report a rare case of Dyke-Davidoff-Masson Syndrome associated with seizures and Pulmonary Tuberculous Disease, emphasizing diagnostic and therapeutic approach.

Background Dyke-Davidoff-Masson syndrome (DDMS), a rare neurological disorder characterized by cerebral hemiatrophy, skull vault thickening, and contralateral neurological deficits, has limited cases reported among adults. Exact pathogenesis is still unknown. Treatment is mainly based on symptoms, but associated comorbidities may complicate management.

Design/Methods NA

Results A 35-year-old-male smoker presented to emergency department with symptoms of left sided focal seizures with impaired awareness, associated with tongue biting, eye rolling, urinary and fecal incontinence. He developed these symptoms in early childhood, and also had cognitive impairment. There was no preceding history of head trauma, intracranial hemorrhage, or altered consciousness episodes. The patient also had complaint of productive cough with hemoptysis, exertional dyspnea, low-grade fever, and weight loss for one month. Physical examination facial asymmetry and decreased bilateral breath sounds. The patient was managed conservatively on anti-epileptic drugs. CT scan brain showed right cerebral hemisphere atrophy. MRI brain revealed atrophy of the right cerebral hemisphere with areas of frontoparietal encephalomalacia changes. Neuroimaging confirmed the diagnosis of DDMS. Gene-expert of pleural fluid confirmed Tuberculosis. The patient was managed conservatively on antiepileptic and antituberculosis medication. The patient was discharged on these medication and follow-up revealed marked improvement of symptoms.

Conclusions This case shows that Dyke-Davidoff-Masson syndrome may present in adulthood without prominent hemiparesis, and high clinical suspicion is necessary in such patients with lifelong seizures and cognitive delay. Neuroimaging is essential for diagnosis, showing classical cerebral hemiatrophy and skull changes. This case also highlights the need for a multidisciplinary approach in patients with coexisting systemic disease, such as pulmonary tuberculosis that may complicate the case. Individualized antiepileptic regimens and follow-up remain essential for optimizing outcomes.

Authors/Disclosures
Muhammad Moiz Javed, MD PRESENTER	Dr. Javed has nothing to disclose.
Syed Mohsin Raza Bukhari, MBBS	Dr. Bukhari has nothing to disclose.
Muhammad S. Raza, Jr., Resident physician	Dr. Raza has nothing to disclose.
Hassan Mehdi, MBBS	Dr. Mehdi has nothing to disclose.
Muhammad Ans, MBBS	Ms. Ans has nothing to disclose.
Amna Zaheer	Miss Zaheer has nothing to disclose.
Muhammad Salman Sajid, MBBS	Mr. Sajid has nothing to disclose.
Syed Ijlal Ahmed, MD, MBBS	Dr. Ahmed has nothing to disclose.

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