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Intracranial lipomas are uncommon, rarely symptomatic, lesions. Those located in the quadrigeminal plate and ambient cistern account for 13% to 43% of cases and are less symptomatic. Of 37 quadrigeminal plate and ambient cistern lipomas reported in the literature, 15 were diagnosed during life, seven in children.1 We had the opportunity to study an additional case of quadrigeminal plate lipoma in a four year old child, who presented with epilepsy and developed behavioural changes tending towards aggressiveness, which both subsided after surgery.
In 1986 the patient presented two episodes of tonic-clonic generalised epileptic seizures associated with fever; the EEG was normal. One year later, although he had benefited from therapy with phenobarbitone, he presented episodes of hypotonia, ataxia, motor incoordination, and confusion. A new EEG study disclosed bilateral paroxistic abnormalities, such as sharp slow waves (figure A). The MRI disclosed a well defined lesion at the level of the left inferior colliculus, which showed a high signal in T1 and low in T2 sequence (figure B). Three months before admission, after the reduction of phenobarbitone dose, the child presented a new tonic-clonic generalised seizure. During the previous two years, his parents had noted …