An uncommon presentation of septum pellucidum anatomical variations: A case report of generalized tonic-clonic seizure in a healthy adult

Abstract

The septum pellucidum (SP) is a thin, transparent, dual-membrane structure located between the lateral ventricles of the brain. Incidentally identified through imaging modalities, this variation, while rare, may manifest with symptoms such as neuropsychiatric disorders, headache, dizziness, seizures, nausea, and vomiting. In this report, we present the case of a healthy middle-aged man with cavum vergae (CV) and cavum septum pellucidum (CSP), who sought medical attention in the emergency department (ED) due to a generalized tonic-clonic seizure (GTCS). A 40-year- old male without any known medical history presented to our emergency department with a GTCS. Considering this as the first seizure, blood and imaging tests were conducted, all of which showed no abnormalities. Non-contrast computed tomography revealed sequel cystic encephalomalacic areas in the left occipital and right frontal cerebral hemispheres, consistent with a parapharyngeal epidermoid cyst, and the presence of cavum septum pellucidum et vergae. Emergency consultation from the neurological clinic was sought, and an electroencephalogram showed no seizure activity. He was subsequently discharged with a recommendation for follow-up at the neurology outpatient clinic. This case prompts critical considerations in the emergency medicine realm regarding the potential relationship between anatomical variations in the septum pellucidum and emergent seizure activity.