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We report the development of intractable epilepsy in 3 patients treated with irradiation to"strawberry"scalp nevi in infancy.Low-dose radiation was used(12 to 13 Gy in 2 of the patients).The clinical evolution suggested a reconizable and distinctive postradiation syndrome.There was concordance between the site of radiation as shown by localized alopecia, the clinical features of partial seizures,and electrographic abnormalities.the clinical picture was unlike delayed cerebral radiation necrosis of adulthood,which is not thought to occur at doses below 50 Gy, in 2-Gy fractions.Neurological deficits were not progressive and in 2 patients there was no evidence of parenchymal injury on cranial magnetic resonance imaging scanning.These differences suggest pathogenetic differences to cerebral radiation injury of adulthood,probably relating to the interaction between nervous system development,individual susceptibility,and the low doses of radiation employed. |
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alopecia
iatrogenic neurologic disorders
radiation therapy,CNS treatment and complications with
seizure
seizure,focal
seizure,intractable
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