So, Fissoa couldn't accept the refuge nobles from Madina, and create the duchy of East Madina (Lesser Madina, Madina in Exile, etc.) in the townsland of Drowentown, since there is a region named "Madina"? Or, hell, why couldn't they call it the Duchy of Madina, since it contains the nobles that still think of themselves as Madinans?
Hm. OK, you've convinced me on realms.
Still think the restriction for regions is reasonable.