Acquired Dyke-Davidoff-Masson syndrome: Revisited

Abstract

Sir, We read an interesting case report of acquired Dyke-Davidoff-Masson syndrome (DDMS) by Aneja et al. [1] The authors have very nicely described the case along with historical aspects, case reports, and case series. Here, we would like to share our experience and views: The authors have pointed out that “most of the available literature is in the form of case reports and a few case series.” The authors have quoted two series described in 2004 and 2010. Here, we would like to share the findings of our case series: [2] We studied 32 patients (21 males and 11 females) among a total of 1182 patients with epilepsy. Of these 32 patients, 28 presented with DDMS. More common presentation was congenital type. Left lateralization with hemispheric atrophy, cerebellar atrophy, calvarial thickening with frontal sinus hyper-pneumatization were significant (P < 0.05) magnetic resonance imaging findings in our patients. Other remarkable findings in our study were cerebral hemispheric and cerebellar atrophy (28.12%), hippocampal sclerosis (16%), dystonia, hemi-parkinsonism, mirror movements, and Dandy-Walker syndrome. In our series, we found 12 (37%) patients in acquired group, of course, we did not analyze the causes of acquired DDMS; hence, we cannot say how many of them were due to infections. Authors have commented on the literature that “some of the patients were reported to have refractory seizures.” We, in our series, found 23 (78%) patients to be refractory seizures One more case series published recently by Jaiswal et al., there was poor seizure control in the acquired group in comparison to the congenital group. [3] The authors have further analyzed the causes of refractoriness. [3] In our series, the overall refractoriness was 78%, in contrast to 81% and 38% poor control in acquired and congenital groups, respectively, in this series of Jaiswal et al. [3] We have tried to compare our case series to that of Jaiswal et al. of course the themes of the series being different. [3] The aim of comparison was that if we compare the data from various regions they are useful as there are wide demographic differences in various parts of India, as are the levels of medical facilities and awareness. [4] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.