# Atypical Presentation of Longstanding Overt Ventriculomegaly in Adults: A Case Report

## TL;DR

A 52-year-old woman with longstanding overt ventriculomegaly showed atypical symptoms, including a breakthrough seizure, despite no focal neurological issues.

## Contribution

Highlights an atypical presentation of LOVA in an adult with a breakthrough seizure as a novel clinical manifestation.

## Key findings

- The patient exhibited macrocephaly and gait issues consistent with LOVA.
- She experienced a breakthrough seizure after years without neurological incidents.
- Radiological findings supported a LOVA diagnosis despite atypical symptomology.

## Abstract

Hydrocephalus involves the enlargement of the ventricular system due to increased cerebrospinal fluid. This condition often presents with ventriculomegaly, associated with cognitive decline, gait disturbances, visual changes, and other neurological symptoms. In adults, hydrocephalus may result from longstanding overt ventriculomegaly in adults (LOVA), characterized by macrocephaly, subnormal IQ, urinary incontinence, and gait issues. In a recent case report, a 52-year-old Hispanic female displayed similar predisposing factors and radiological findings for a LOVA diagnosis. Despite the absence of focal neurological deficits or typical complaints, she experienced a breakthrough seizure episode after years without incident.