Olfactory sensory phenomena as the main seizure type in a child with low-grade glioma: a case report.
Level 4 - case-series / case-control
Single clinical case report
PubMed 41103526 · doi:10.1016/j.ebr.2025.100830
What was done
Clinical evaluation and treatment course of a 7-year and 9-month-old boy presenting with recurrent olfactory sensory phenomena (OSP). Diagnostic workup included brain magnetic resonance imaging (MRI), histopathological evaluation, and monitoring of seizure response to lacosamide and perampanel.
What was found
OSP served as the sole seizure manifestation for nearly a year and was initially misattributed to gastroesophageal reflux before progressing to focal impaired consciousness seizures. MRI and histopathology confirmed a structural low-grade glioma involving the right optic nerve, hypothalamus, and medial temporal lobe. OSP persisted under lacosamide therapy, and subsequent initiation of perampanel led to an increase rather than a reduction in OSP frequency. The abstract provides descriptive findings for this single patient without aggregate statistical numbers.
Why it matters
This case demonstrates that recurrent isolated olfactory sensations in children can be the primary sign of focal epilepsy secondary to low-grade brain tumors. It also illustrates a potential paradoxical worsening of sensory seizure frequency with perampanel.
Limits
This is an uncontrolled single-patient report (n = 1), preventing causal conclusions regarding drug efficacy or generalizability to other pediatric brain tumor cases. Abstract data lack long-term surgical and functional outcomes.
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