• |
  • |
08.10.2009
הדפס  
A 26 year-old female with intractable partial seizures. with no lateralizing features.
Scalp VEEG showed interictal spikes broadly distributed over the right posterior-temporal region. Seizure activity was non-localizing.

Crytogenic Lateral Temporal Lobe Epilepsy

CASE STUDY: Cryptogenic Lateral Temporal Lobe Epilepsy

Physician: Robert Knowlton, M.D.,
University of Alabama, Birmingham.

Case study:
A 26 year-old female with intractable partial seizures. with no lateralizing features.
Scalp VEEG showed interictal spikes broadly distributed over the right posterior-temporal region. Seizure activity was non-localizing.

MRI was normal.

FDG-PET showed a questionable focal relative hypometabolism in the right posterior temporal area.
An MEG study was conducted using a 4-D Neuroimaging Magnes II 74-channel sensor configuration. MEG spike localizations showed a focal cluster in the right posterior temporal area corresponding exactly to the possible PET abnormality.
The agreement between the MEG and FDG-PET data, which were consistent with the scalp EEG, was sufficient to send the patient to surgery.

A cortical resection with ECoG was performed. The pathology showed a neuronal dysgenesis.
The patient had no residual deficits and was seizure-free after surgery. 

Conclusion:
The combination of non-invasive MEG and scalp EEG, with minimally-invasive FDG-PET was sufficient to define a surgical plan that rendered the patient seizure free, even though the MRI was non-diagnostic.