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An 83-year-old healthy woman was admitted with episodes of nausea and vertigo that had increased in frequency over several months. Many of the episodes involved brief periods of unresponsiveness and staring spells. She did not report a history of seizures, head trauma, headache, or vestibular disease. The neurologic examination did not reveal papilledema or any other abnormalities. Computed tomography of the head showed a large (5 by 5 cm), well-circumscribed, and highly calcified extra-axial mass overlying the right temporal lobe. Electroencephalography showed mild slowing and occasional sharp waves in the right temporal area. A diagnosis of temporal-lobe seizures due to a meningioma was made. Surgical intervention was withheld in favor of medical management. The patient was treated with lamotrigine, and within 6 months her symptoms had resolved. She resides with her daughter but continues to live independently. She reports no further seizures and no new symptoms associated with the meningioma at 2 years of follow-up.
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