Mystery case: Cowden syndrome presenting with partial epilepsy related to focal cortical dysplasia.

[cowden syndrome]

A 55 -year -old man presented with seizures characterized by "tightening " of the right side and variable loss of awareness . EEG showed focal epileptogenic abnormalities over left and midline central regions . MRI showed left frontal focal cortical dysplasia (figure 1 ). He had multiple skin lesions (figure 2 ) and colonoscopy revealed gastrointestinal mucosal ganglioneuromas . Genetic testing of PTEN gene confirmed a diagnosis of Cowden syndrome (CS ).